Varicose veins - surgery

Apr 7, 2012 , Kateřina Hudecová

krecove-zily-operace.jpg - kopie
krecove-zily-operace.jpg - kopie
Varicose veins are an unpleasant disease of the veins of the lower extremities, where the venous wall swells and the venous valves malfunction. The aim of varicose vein surgery is to remove the affected veins, especially when the disease is at an advanced stage. An alternative to conventional surgery for varicose veins is CHIVA method.

Varicose vein surgery

Varicose veins are one of the most common diseases affecting the veins, and are manifested in approximately half of our population. They appear mostly on the superficial veins of the lower extremities, where they can be seen as emerging sinuous veins. Varicose veins affect approximately twice as many women than men. Previously it was a disease of older people, but today also young people have varicose veins. Varicose vein surgery is one of the methods to effectively get rid of this disease.

Causes of varicose veins

Varicose veins are caused by excessive swelling of the venous walls and subsequent accumulation of blood that can not flow out of the limb. Swelling of the venous wall is also related to malfunction of the valves, which are abundant in the veins of the lower extremities. The valves are unable to perform their function, thus preventing backflow of blood. This leads to the accumulation of blood. The swelling of the venous wall occurs due to various reasons. In consideration comes hereditary predisposition to weakened venous walls, excessively prolonged standing or sitting, pregnancy and the effect of female sex hormones.

Symptoms of varicose veins

Varicose veins are an unpleasant condition for the patient, they may reduce the quality of life, burden it by pain, or also not so appealing appearance due to the zigzag emerging veins. At first the varicose veins are asymptomatic, but later starts leg pain and a feeling of heaviness, especially in the evening. Also, there may be swelling, especially around the ankles. In the later stages, there are also changes in skin pigmentation due to the decomposition of the accumulated blood. In this area varicose ulcers or blood clots easily form.

Treatment of varicose veins

Although varicose veins do not have initially pronounced symptoms, they can make life difficult for the patient due to their unfortunate cosmetic effect. Treatment of varicose veins is necessary primarily because of the possibility of complications, including inflammation of the veins, chronic venous insufficiency, varicose ulcers and eczema. If larger venous trunks are affected, it is necessary to proceed to surgery for varicose veins.

Conventional varicose vein surgery

Varicose vein surgery is the best treatment mainly for developed varicose veins of the lower extremities. The procedure is now mostly done under local anesthesia, the patient remains conscious, but also total anesthesia is possible, where the patient is put to sleep for the surgery. During the operation connections between the superficial and deep venous system of the lower limbs are interrupted, so it is therefore necessary to properly check the patency of the deep venous system before the procedure. If the superficial veins would be removed and the deep venous system would be blocked, the outflow of blood from the lower extremities would be impossible. The aim of the conventional operation is to eliminate all varicose veins that are redundant and unfunctional, and after surgery will be dispensable. The disadvantage is that this type of treatment is difficult, painful and less considerate to the patient. Therefore, it is less common in practice, and if it is possible a different operating method is chosen.

Mini-invasive method of varicose vein surgery

Another type of surgery is the so-called minimally invasive surgical method CHIVA. This is a very effective procedure that completely removes the patient's varicose veins. This method is very gentle to the patient because it does not remove the entire vein, but only the damaged part. It can be used also for smaller veins outside the main trunk. Its great advantage is that it can be performed outpatient using local anesthesia and the patient can go home immediately after the procedure. After the treatment, it is recommended to wear compression stockings for at least 2 weeks. It is appropriate for a period of 4-6 weeks to avoid sports activities, especially skiing, or dancing. This method is very effective, but even here we meet with recurrence, i.e. return of the disease. This, however, depends on the genetic predisposition of the venous walls.

Laser treatment for varicose veins

Currently a widely used new method for the treatment of varicose veins is laser treatment. It is a modern type of non-surgical treatment of varicose veins. In this method, through small punctures in the groin an optical fiber laser is introduced into the interior of the affected vein. The vein is then sealed and blocked by laser irradiation. It is then possible to remove the affected vein, or leave it in place and the body gets rid of it itself. The procedure is performed under local anesthesia and takes approximately 60 minutes. The patient can go home in the company of another person already two hours after surgery. A big advantage is only small pain, less recovery time and less postoperative consequences, especially bruises. The disadvantage is that laser treatment is not suitable for certain types of varicose veins. The treatment of varicose veins by a laser is highly effective, but there is a possibility of recurrence. However, currently this method is not covered by insurance, so patients have to pay it themselves.

Selection of appropriate methods of treatment of varicose veins

About when and for whom it is appropriate to proceed to surgical treatment of varicose veins decides the doctor. For each patient the decision is different and the doctor can correctly assess what procedure is best for the patient. Often surgery is performed for cosmetic reasons or in situations where the patient has significant difficulties or there is a risk of serious health complications such as swelling, inflammation, venous thrombosis, or the formation of varicose ulcers. It is also necessary to keep in mind that the varicose veins are not life-threatening, so it is necessary that the operation is safe for the patient, and the risk is minimal. It is not recommended to operate older patients, people seriously ill, or individuals with blood circulation disorders and swelling of the lower extremities. Also, it is not recommended to operate pregnant women or women during the first year after birth.

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