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Disease Information : Varicose Veins : Treatment

Varicose Veins: Treatment

Varicose Veins Treatment Options

The treatment of primary varicose veins depends on the extent of the varicosity. Graduated elastic compression stockings may reduce the symptoms of varicose veins, prevent leg swelling, and decrease the risk of blood clots. However, in hot environments, the use of elastic stockings may be impractical. Sclerotherapy is an injection of a sclerosing solution into spider veins (telangiectases), reticular, or small varicose veins to block these veins. It is considered a minimally invasive outpatient procedure offering best results in limbs with localized areas of valvular incompetence.

Ambulatory phlebectomy is also a minimally invasive outpatient procedure that can be performed under local, epidural, or general anesthesia. Varicose veins are removed with hooks through small skin incisions. Stitches are not necessary, and the incision edges are held together with fine paper-tape. Recovery is brief and uneventful.

Venous stripping is the standard treatment of valvular incompetence of the great saphenous vein. The great saphenous is the largest superficial vein along the inner thigh and calf and generally receives the most varicose veins. Usually the thigh portion of the great saphenous vein is stripped (removed) after its junction with the deep veins and its branches are disconnected (a procedure called high ligation) through a small groin incision. Multiple fine incisions are made to allow removal of the varicose veins. The entire procedure is safely performed under general, epidural, or spinal anesthesia.

New minimally invasive treatments have been developed in the past five years to reduce the need for surgery in limbs with valvular incompetence of the great saphenous vein. A radiofrequency (Closure) or laser energy (Endovenous Laser Therapy, EVLT) catheter is threaded into the great saphenous vein at the level of the knee, through a small needle puncture, and is advanced to the groin, where it is positioned using duplex ultrasonography. Release of radiofrequency or laser energy at the tip of the catheter, as it is shifted from the groin to the knee under ultrasound guidance, results in an effective, long-term closing of the great saphenous vein opening, replacing surgical venous stripping. Both of these methods avoid the groin incision and the vein strip that are part of the standard surgical treatment.

Variable size varicose veins scattered over the calf and thigh may be eliminated via two small skin incisions alone, with a powered mechanical aspirator system (Trivex), in contrast to the multiple stab wounds of the standard surgical procedure. A strong light-source inserted under the skin through one of the incisions illuminates the varicose veins, which are eliminated with a thin mechanical aspirator inserted through the other incision.

What You Can Do

You can’t do anything about your heredity, age, or gender. However, you can help delay the development of varicose veins or keep them from progressing.



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