Varicose veins are quite common and prevalent. They can vary from tiny spider veins to large, prominent bulging veins. Most of the time they occur on the legs and feet and can cause ulcers and bleeding around the foot. Around 7% of the world’s population suffers from some form or other of varicose veins.
While about two decades ago, the most common treatment for varicose veins was open surgery, this has changed quite significantly since then. Today, varicose veins are typically treated by minimally invasive procedures and treatments. In this article, we’ll talk about the different varicose veins treatment options, ranging from minimally invasive procedures to surgery.
Minimally Invasive Procedures and Treatments
Certain minimally invasive procedures and treatments have been developed for varicose veins treatment without surgery. These are typically carried out by interventional radiologists, who are specifically trained in using techniques such as ultrasound to treat varicose veins without surgery. Some of these techniques are:
- Sclerotherapy: This is also called injection therapy. During this procedure, the physician injects a chemical irritant, either a liquid or foam, into the vein. This makes the vein swell, stick together, and seal shut. Your blood circulation is not impaired because the healthy blood vessels that are near the injection site compensate for the vein that has been closed off. Sclerotherapy requires more than one session since each vein must be injected at least one to three times. Sessions last from 15 minutes to an hour and no anaesthesia is required. Once blood is no longer flowing through the vein, scar tissue develops and the vein fades. There is a very small risk of an allergic reaction so make sure that you consult with your doctor if you have any allergies.
- Venous Ablation: During this procedure, a thin tube or catheter is inserted into the varicose vein. By using ultrasound, the path of the catheter is followed. Once the tip is in the right position, heat made by either a laser fiber or radiofrequency waves is applied to the inside of the vein. This results in the vein closing off and eventually disappearing.
- Microphlebectomy: During this procedure, small nicks are made in the skin around the vein. A specialized instrument is then inserted through the incisions and into the affected veins. The latter are then removed and this procedure is often done along with venous ablation. This procedure is also called ambulatory phlebectomy.
- Endovenous Laser Treatment (EVLT): During this procedure, your physician will first confirm all of your weak veins using a Colour Doppler Ultrasound Scan. He will also determine the best place to insert a catheter. You will have to wear protective glasses because he will be using a laser and the area will be numbed using a local anaesthetic. A small incision is made into your skin and a catheter and guide-wire are inserted. Then, a laser fiber is passed through the catheter and is secured in place when it extends about 1 to 2 centimeters from the end. The energy from the laser seals the faulty vein and redirects blood flow to the healthy veins. This entire process takes about an hour and is an effective laser treatment for varicose veins.
Pros of minimally invasive procedures
- These treatments are effective, with Endoscopic venous ablation being effective almost 91% to 100% of the time.
- These treatments are outpatient procedures that can be performed outside of a hospital.
- These treatments do not require stitches.
- These treatments usually only require local anaesthesia.
Cons of minimally invasive procedures
- Your varicose veins may not be treatable with minimally invasive procedures. You should speak to your doctor regarding your treatment options.
- You may need certain, additional treatments.
- You may suffer from side effects such as infection, bleeding, and inflammation of the vein.
- You may suffer from the rare complications of endovenous treatment such as blood clots.
Surgical Procedures and Treatments
Surgical procedures to treat varicose veins have been around for a long time. These procedures are performed by vascular surgeons who perform vein stripping and ligation.
- Vein stripping and ligation: You will need medication to sedate you during the surgery as well as local anaesthesia to numb a portion of your body. A small incision is made in your groin and around the blood vessels in your calf. After this, the varicose veins are found and tied off and the superficial veins are removed.
Pro of surgical procedures
- This is considered a safe and effective treatment
Cons of surgical procedures
- This procedure requires sedation, which increases the risk of complications.
- This procedure has a longer recovery period and is more painful than minimally invasive procedures.
- This procedure is not foolproof, and has a 50% chance of recurrence after 5 years.
- This procedure may result in nerve injury in a third of patients.
- This procedure may result in deep vein thrombosis in about 5% of people who have been through this surgery. This type of blood clot can occur in the deep veins and can move to the lungs. This can cause pulmonary embolism, which could be life threatening.
Self-care for varicose veins
Besides these forms of minimally invasive and surgical approaches to treating varicose veins, you can also practice a good amount of self-care if you have varicose veins. You can do this in several different ways:
- Put your feet up: Take a 15-minute rest several times in a day. You should raise your legs above the level of your heart so that your veins do not have to work against gravity.
- Change leg activity: Avoid prolonged sitting or standing if you can manage to do so. If you do sit or stand for long periods, take brisk, frequent walking breaks. Do not sit with your legs crossed.
- Be active: Indulge in regular exercise, such as brisk walking to improve circulation. Exercise also tones the calf muscles, which helps blood move through the veins.
- Take a pain reliever: If you have occasional, mild aching from varicose veins, you can take acetaminophen, aspirin, or ibuprofen to relieve the pain.
- Wear compression stockings: Elastic stockings put pressure on the leg veins and prevent blood from pooling or flowing backward. If your symptoms are mild to moderate, you can buy and use regular support stockings or over-the-counter compression stockings. However, if your symptoms are more severe you should consult your clinician, who will prescribe a graduated compression stocking that applies decreasing pressure from the ankles to the thighs. You should put the stockings on immediately after you get out of bed in the morning.
- Wear loose clothes: Do not wear tight clothing around the waist or legs.
While there are several different techniques, procedures, and approaches to treating varicose veins, it is imperative that you consult a skilled vascular surgeon. One such surgeon is Dr. Abhilash Sandhyala at the Flow Vascular Clinic, in Hyderabad, India.
He is extremely skilled at treating varicose veins and uses EVLT widely in his practice. He will recommend the best treatment for varicose veins for you. His success rate at using the EVLT procedure is very high. He will work closely with you to determine the prevention and treatment procedures that are right for you in treating your varicose veins. He will also determine if varicose veins treatment without surgery is right for you.
He will never rush you and will answer all of your questions patiently and with empathy. He will work with you right from the first consult through to post-surgery. So, the next time you intend consulting a doctor for your varicose veins, you know where to go…to Dr. Abhilash Sandhyala for that perfect outcome!
For more information about varicose veins treatments, as well as the treatment for DVT, or other vascular conditions, contact Dr. Abhilash Sandhyala at (+91) 9989649498 or 9959033037, or at [email protected] or visit our website at www.drabhilash.com
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Dr. Abhilash Sandhyala · Flow Vascular Clinic, Kukatpally, Hyderabad