Varicose vein therapy

Definition

Varicose vein therapy is used to remove enlarged veins (varicose veins) that have problems with their valves.

Description

Varicose veins usually occur in the legs. Normally, valves in your veins keep blood flowing. But the valves in varicose veins are either damaged or missing. This causes the veins to remain filled with blood, especially when you are standing.

Varicose veins can be treated by removal (vein stripping) or occlusion of the vein. Small vericose veins can be treated with an injection with a salt solution (sclerotherapy).

These procedures do not usually cause circulation problems because the blood is re-routed through deeper veins in the legs.

• Surgical vein stripping is done in the hospital while the patient is under general anesthesia. Incisions are made at the bottom (ankle end) and the top (groin end) of the varicose vein. A thin, wire-like instrument is inserted into the vein. That "strips," or clears, the vein from the inside. Small incisions can also be made over individual veins to remove them.
• Sclerotherapy is done while the patient is standing. The salt solution is injected into each varicose vein to cause scarring that closes off the vein. An elastic bandage is wrapped snugly around the legs after the procedure.
• Endovenous ablation therapy is an outpatient procedure. The therapy uses heat to destroy vein tissue. A thin catheter (or tube) is inserted into the vein through a tiny skin incision under local anesthesia. Then, using either a laser or radiowave (radiofreqency) energy, the vein is heated and cauterized. This closes off the vein.

Today, fewer doctors are performing the traditional vein stripping surgery as more patients opt for the less invasive endovenous ablation procedure. The endovenous ablation procedure has shown to work the same as or better than surgery. Patients have significantly less pain and a quicker recovery.

Indications

Varicose vein therapy may be recommended for:

• Varicose veins that cause circulatory problems (venous insufficiency)
• Skin irritation and sores (ulcers)
• Blood clots in the veins (phlebitis), which can travel to the heart, lungs, or brain (embolism)
• Cosmetic purposes

Risks

The risks for any anesthesia include:

• Reactions to medications
• Problems breathing

• Bleeding
• Infection

• Blood clots (call your doctor if your feet become cold or change color)
• Irritation of the vein from the sclerosing solution
• Blocked blood flow caused by the sclerosing solution
• Leakage of the sclerosing solution out of the veins into other tissue (which can damage the surrounding tissue and form ulcers)
• Thermal injury (burn)
• Bruises
• Nerve injury
• Return of the varicose veins

Expectations after surgery

Most patients who undergo varicose vein surgery have good results. Some patients, however, have inflammation and skin discoloration that last for several months following surgery.

Talk to your physician about these risks and your chances for good results.

Convalescence

After endovenous ablation therapy and sclerotherapy the patient can almost immediately resume most of their normal activities.Surgical stripping usually requires an overnight hospital stay and several days of recovery.

After treatment your legs are wrapped tightly in bandages. Walking is possible the day of surgery. In fact, walking is encouraged to minimize swelling and avoid the risk of deep venous thrombosis. It is important that feet are kept raised above the heart whenever possible.

Illustrations

Circulatory system

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Vein stripping; Sclerotherapy of veins; Endovenous ablation therapy ; vein stripping; varicose vein stripping; stripping vein video; ablation endovenous therapy; sclerotherapy varicose vein; vein sclerotherapy; sclerotherapy spider vein