The treatment of varicose veins of the legs is an easy task as for a doctor-phlebologist, and for the patient. This is connected with various forms and stages of the disease require very different therapeutic measures. Plays an important role and the principle of minimum injury, and the rehabilitation of the patient. Effective, however, sparing treatments are hi-tech and require the availability of modern medical equipment and qualified professionals-phlebologist.
Methods of treatment for varicose veins:
- Conservative activity
- Surgical techniques
Almost always, the methods of treatment used together, successfully merging and complement each other.
The conservative treatment of varicose vein disease.
It is a complex of activities aimed to reduce the risk of complications varicosity and to improve the quality of life of the patient. This method does not eliminate the varicose veins and, therefore, requires a constant application.
- The correction of the life style – activities aimed at the formation of the so-called muscle pump venous. Muscle-venous hydraulic – a sort of pump, ensuring the outflow of venous blood from the lower limbs. The operation of this pump is possible thanks to the joint work of the muscles and the veins of the legs. Muscle contraction occurs compression of veins, it flows-within and between muscles, in this way, the blood moves towards the heart. The training includes a series of dynamic exercises of sports load. Very useful are the swimming, the exercise bike, nordic walking, cross-country skiing. It is necessary to eliminate the long static load on the legs. To improve the venous outflow useful the so-called pastoral drainage during the day, namely, the adoption of postures in which the legs are in raised position, which contributes to venous outflow. For example, a sort of "poses cowboy" - when sitting on a chair a man puts his feet up on the desk. Useful respiratory gymnastics, because the correct deep breathing stimulates the flow of blood. We recommend that you exclude the overheating of the body, as this greatly reduces the tone of the veins. The resulting venous stasis is a factor in the offensive wall of the veins.
- The diet is an important component of therapy. The food must contain a sufficient amount of vitamins and minerals. A proper diet favours normal saline shipping. In the absence of constipation and frequent swelling persists the normal outflow of venous blood from the lower limbs, and decrease the likelihood of the lesions of the veins.
- Compression therapy includes the use of a variety of bandages, of servitude, of meshes, of mechanical devices. On the surface of the foot creates pressure, which is transmitted in depth, you find tissue and has a therapeutic effect or prophylactic action.
The main meaning in compressive treatment has currently compression stockings medical. The fact the elastic bandage of the legs is now used a lot less. The advantages of compression shirts before the bandages are obvious: simplicity and comfort of fit, while maintaining the necessary physiological and measured the pressure. The bandage of the foot is used in special cases: when the special shape of the legs, in complex cases, the current venous trophic ulcers, in certain stages of surgical treatment of varicosity. The right dressing is a complex process, is possible only under the supervision of a physician.
The selection of genre, form and class of knitting must be carried out by a specialist. This is due to the fact that there are some contraindications to wear graduated compression stockings for health products. For example:
- heavy cardio-pulmonary insufficiency is a contraindication for compression of the legs.
- important the maximum efficiency of a given product in the individual patient.
- in the treatment of chronic diseases in the veins, in particular in cases of varicose veins, which are accompanied by significant venous edema of a certain importance has the so-called variable compression, created with the help of devices dynamic pneumocompression.
- The medicine in the treatment of varicose vein disease fundamental importance are the so-called phlebotropic drugs (synonyms – vienna active drugs, phleboprotector). This is a large group of drugs, able to reduce the severity of chronic venous swelling and other symptoms of chronic diseases the veins. Unfortunately, phlebotropic drugs do not restore varicosity changed to vienna. The drugs of this group prescribed in the form of courses for 2-4 months. Effective, these instruments only in the case of ingestion.
- The most effective method of physiotherapy varicose veins is electro muscle stimulation of the lower limbs. This method can be used when medications and compression stockings for various reasons, are contraindicated. Like other conservative activities, this method does not eliminate varicose veins, but reduces the manifestation of concomitant venous insufficiency. There are individual portable devices for self-electro muscle stimulation.
Sclerotherapy is the main method without operative treatment varicosity. The essence of the method is very simple: in the varicose vein through a syringe is introduced a special medicine, and foot overlapping compression. The result is the closure (occlusion) sick phase of the vessel. Following varicose veins disappear completely. The blood moves in the veins are healthy, it improves the circulation of blood in the foot. When they disappear not only advanced to vienna, but also the clinical manifestations of the disease – pain, swelling, cramping, heaviness in the legs. The procedure for a long time, and often for the whole life, ensures good healing and cosmetic direct. Low cost, minimum risk of injury, the combination of a good functional outcome with high cosmetic effect, are the hallmarks of this method.
Modern sclerotherapy of large varicose veins and trunks of subcutaneous veins takes place the foam form under the control ultrasound scanner – micro-foam (foam-form) echo-sclerotherapy. Micro-sclerotherapy "varicose veins" is performed under the control of a special device – transilluminator.
Sclerotherapy as a self-healing procedure performed:
- isolated varicose tributaries of the subcutaneous veins;
- the reticular varicosity ("vascular");
In some patients, with the goal of reducing operating injury and improve the aesthetic result of the sclerosis to pass a certain period of time after the surgery. Phlebosclerotic used for the treatment of recurrent varicosity, with the aim to stop and prevent bleeding from varicose veins, and also in some forms of congenital angiodysplasia.
Contraindications for the application of sclerotherapy:
- Severe systemic diseases (heart or pulmonary failure, hepatic insufficiency, etc.)
- Local or joint infection
- The need to comply with bed rest
- Expressed allergic reactions
- Pregnancy and breast-feeding
- Of the state in which it is contraindicated for compression therapy and walk
Surgical techniques for the treatment of varicose veins
Surgical interventions for varicose veins of the legs are the most radical method of treatment. The vast majority of modern minimally invasive surgeries can be performed in outpatient settings or in hospitals, surgical one night stay.
The scientific and technological progress has caused a revolutionary change in the treatment of varicose veins of the lower limbs. After the introduction in clinical practice called phlebologists high-energy laser, endovasal laser obliteration (ELO) has become the standard minimally invasive treatment of varicosity. The essence of ELO is to break the varicose vein a laser beam. This technique is not an operation in the traditional sense. The cuts do not need to, all manipulations carried out through the micro holes. The surgery is performed as an outpatient procedure under local anesthesia and the patient is in the hospital does not require. All operations are conducted under visual and ultrasound control. Through a small hole in the lower part of the thigh or of the upper part of the tibia injected into a vein thin flexible laser, fiber optics. After this tour of vienna is injected with a solution of anesthetic for the pain. Mode of work through a light-guide, is served strictly dosed solar thermal energy, which causes the complete closure (occlusion) and more obliteration ("vegetation").
The patient remains quite active in day mode with the minimum of discomfort. ELO-effectiveness, and also the minimum possibility of injury goes far beyond the methods of classical operations.
There are no restrictions for the application of ELO:
- Extremely launched varicosity, with a considerable extension, and the curved trunk of the subcutaneous veins. In these cases, the indicated combined phlebectomy.
- Repeated interventions on the subcutaneous veins. In these cases, the possibility of applying ELO is specified individually in each patient in-depth examination.
Large varicosity advanced tributaries stem veins are currently being removed with the help of this delicate procedure, such as ambulatory mini-phlebectomy. This surgery is performed under local anesthesia with special instruments through micro punctures of the skin. Is usually performed immediately after ELO or used as a method of self -. Hospitalization and anesthesia is not required. Feeling of pain and discomfort in the post-operative period is minimal. When large veins veins the cosmetic result is often greater than the sclerotherapies.
The classical operation is indicated in cases of large run of defeats. As a general rule, is admitted to the hospital for vascular surgery. The intervention performed with the help of anesthesiological study – anesthesia or regional (spinal) anesthesia. These operations refer to the combined phlebectomy, endosurgical dissection final. incontinence of veins the perforators. This group of operations which enjoys a long period of rehabilitation, often unsatisfactory cosmetic result. Often complications occur as thrombophlebitises, damage to healthy tissues, the nerves, the first relapse of varicosity.
In conclusion, we must say that, in spite of the difficult integrated approach in the treatment of varicose vein disease, this disease can be successfully treated now.