- 03/July/2019
Varicose Veins Treatments, Procedure - Ananthapuri Hospitals, Trivandrum
If you have varicose veins and it is not causing you any discomfort - you may not need to have treatment. But if your varicose veins condition is causing you pain or complications such as ulcers, discolouration or swelling, then you need treatment.
Discomfort and complications are caused due to the deoxygenated blood being refluxed back to the leg tissues. The main goal of treatment of varicose veins is to remove these reflux veins altogether. Once the veins are removed, your blood flow is improved. And once the blood flow is improved, your symptoms are reduced.
Know the various treatment options for varicose veins:
CONSERVATIVE APPROACH
At first, your doctor may ask you to:
- Exercise regularly
- Lose weight
- Avoid wearing tight clothing
- Elevate your legs
- Avoid standing or sitting for long periods
- Wear compression stockings
If these approaches do not improve your condition, your doctor may consider other therapy modalities, which may include minimally-invasive or surgical treatment.
MINIMALLY INVASIVE TREATMENTS
ENDOVENOUS LASER THERAPY
Endovenous laser therapy is a minimally-invasive ablation technique, in which a laser fiber is inserted through a catheter inside the affected vein. Before starting the procedure, doctors usually inject an anaesthetic drug into the vessel to reduce the resultant pain.
- What happens during this procedure?
The laser is fired continuously from the fiber into the vein, to damage the inner lining of the vein. This causes damage through the length of the vein, causing it to close up and be absorbed by the body. The laser is then slowly withdrawn from the vein.
- What are the risks?
Common complications of endovenous laser therapy include transient abnormal sensation (pins and needles), which resolve spontaneously.
RADIOFREQUENCY ABLATION
Radiofrequency ablation is also a minimally-invasive ablative method of treating varicose veins. It is done using a specially developed radiofrequency (RF) catheter.
- What happens during this procedure?
In this procedure, the special RF catheter is passed along the affected vein through an introducer sheath placed at the upper end of the varicose vein. The catheter is advanced until the tip reaches a certain point.
After advancing the catheter, an anaesthetic drug is injected into the vein to numb the potential pain from ablation. Thermal energy is then released through a probe guided into the vein along the whole length of the vein. The catheter is withdrawn gradually as the vein is ablated. The lining of the veins are destroyed and the vessel wall eventually seals shut. The closed vessel is absorbed by the body after some time.
Compression is important after the procedure: You will be asked to wear compression stockings for up to a week to reduce bruising and tenderness that may occur after the procedure. Also, compression stockings help reduce the risk of deep venous thrombosis after the procedure.
- What are the risks?
Radiofrequency ablation has a minimal risk of complications. Common risks include loss of sensation or abnormal sensation in the area and deep venous thrombosis. However, these risks are generally rare.
Invasive techniques can also be used to treat varicose veins. These are recommended when conservative and minimally-invasive techniques fail.
STAB AVULSION OR AMBULATORY THERAPY
This technique involves removing short segments of the varicose veins using special phlebotomy hooks passed through tiny skin incisions made over the vein.
- What happens during this procedure?
With the patient standing, duplex ultrasound is used to detect the locations of the defective veins before making the incisions.
The phlebotomy hooks pull out the vein until it cannot be pulled any further, detaching it from its branches. Scarring is minimal in this procedure.8
SCLEROTHERAPY
Sclerotherapy, also called chemical sclerosis or endovenous chemoablation is the most common medical technique for treating varicose veins. Sclerotherapy is offered if ablative (surgical treatment involving removal of tissues) techniques are not suitable for you.
- What happens during this procedure?
A thickening substance called sclerosant is injected into the defective vein to produce a thickened wall that eventually seals the vessel. The sealed vessel is absorbed by the body after some time and blood flow is redirected to the healthy veins. You may need more than one session of sclerotherapy to successfully treat varicose veins.
- What are the risks?
The most commonly used sclerosants for this procedure today include chemicals such as polidocanol and sodium tetradecyl sulfate - both have a low risk of causing allergic reactions and are less likely to cause severe adverse effects to the skin once injected.
Highly concentrated or hypertonic sodium chloride is also used as a sclerosing substance. The advantage is that sodium and chloride are natural blood contents and it has minimal risk of causing toxic effects.
NON-INVASIVE TREATMENT
LASER THERAPY
This technique is also called Transcutaneous Pulsed Dye Laser and Intense-Pulsed Light (IPL) therapy. It is an effective therapy for treating varicose veins. However, it is only used when other simpler forms of treatment, such as sclerotherapy, have failed.
- What happens during this procedure?
An ablative dose of light energy is delivered to the defective vessel to damage the inner lining of the vein and cause it to seal off. The sealed off vessel gets absorbed into the body with time, and blood is redirected to the healthy veins.
- What are the risks?
Patients could sustain skin burns that could leave an ugly scar with laser therapy.
TRANSILLUMINATED PHLEBOTOMY
Transilluminated phlebotomy is a relatively new procedure and its use has not been fully established.
- What happens during this procedure?
In this procedure, doctors make small incisions in the leg to remove the diseased veins with the aid of a special light called endoscopic transilluminator.
SURGICAL TREATMENT
SAPHENECTOMY
Saphenectomy is also an invasive approach to treating varicose veins and it has largely been replaced by minimally invasive modalities.
- What happens during this procedure?
The surgeon makes a large incision in the groin to expose the junction of two great thigh veins – the saphenous and femoral veins – in the upper thigh. A stiff, flexible wire is passed into the vein to strip the defective vein and pull it out of the leg.
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Ananthapuri Hospital has a team of excellent vascular surgeons who can provide expert care and a wide range of treatments for varicose veins. To book an appointment, call us at +91 9400332777 or visit our hospital at Chacka, NH Bypass, Thiruvananthapuram.
Click link to read more about the causes and symptoms of varicose veins | http://www.ananthapurihospitals.com/ananthapuri_blog/image_blog/49