Varicose veins refer to enlarged, swollen and twisted veins that occur when the valves in veins allow blood to flow in the wrong direction or pooling of blood in the leg.
The varicose veins appear bulging and blue or purple on the surface of the skin.
This disease is very disturbing – mentally and physically for the patient and often, patients are desperate to get rid of the varicose veins.
Here in this article, we will discuss-
- Different types of varicose veins treatments
- Tips for recovering post-surgery.
- What kind of precautions should be taken after the surgery?
It is essential to treat varicose veins at the beginning because if left untreated for long, multiple severe problems can develop which can cause a lot of morbidity to the patient and overall quality of life of the individual goes down drastically.
Types of varicose veins treatment
Fortunately, most of the procedures of varicose veins don’t require a hospital stay, and there is also no need to stay in bed for long.
Numerous treatment options are available to treat varicose veins and get rid of it. But unfortunately, not all treatments are proved to be effective and safe.
Here is the list of varicose veins treatments that work:
Most Effective Types Of Varicose Veins Treatments:
- Endovenous treatments (Laser / Radiofrequency / Glue / Sclerotherapy / Mechanico-chemical ablation – MOCA)
- Laser therapy.
- Compression stocking.
- Vein stripping and ligation.
- Endoscopic vein surgery.
The vascular surgeon uses different procedures to operate patients. They recommend and perform treatment according to the patient’s disease severity and distribution. They always make sure that the patient faces minimal damage to the body and heals as quickly as possible after the surgery.
- Minimally invasive surgery
One of the most effective treatments to cure varicose veins is a minimally invasive treatment.
Don’t get afraid by the word surgery. It is not like traditional surgery in which surgeons make big and deep cuts. Instead of that, hardly any incisions are required and no sutures are there on the leg.
Minimally invasive surgery associates with less damage to the normal tissue and less pain and also requires a short hospital stay.
The basic concept of minimally invasive/endovascular surgery is to enter the faulty vein through a ~ 2 mm hole in the skin and close off / burn the vein within the body and come out.
Types of minimally invasive surgery
- Laser treatment – EVLT (Endovenous laser treatment
- Radiofrequency ablation – RFA
- Endovenous Laser Therapy (EVLT)
In EVLT procedure, through a small hole in the skin, a small catheter is inserted into the varicose vein and through this catheter, laser inside the vein.
The heat damages the vein’s wall, and this causes the veins to collapse or shrink.
The ablation procedure is safe, and it hardly leaves any scar on the skin after the surgery. Immediately after the process, the patient can return to daily activities.
This procedure is also known as venous ablation, and it gives excellent long term results.
Patients can resume their everyday activities immediately after the treatment.
This procedure is also known as Ambulatory phlebectomy. In this treatment, about 1-3mm length incisions are required on the skin to remove diseased veins in small segments.
Specialised equipment with an attached hook on it will be inserted inside the vein by those incisions and used to take out the varicose veins.
There are no sutures needed after the treatment. Usually, this procedure hardly takes 30 minutes to 1 hour. Within 4 hours of the procedure, you can start your regular activities.
This therapy is used to treat small varicose veins or spider veins. In this procedure, the doctor injects a liquid chemical or foam solution into the varicose veins by using a needle. The solution causes the vein to seal, and the body absorbs the veins.
This procedure doesn’t require any anaesthesia, and it takes about only 15-20 minutes. Treatment time may vary upon the number of veins being treated.
Patients can resume their day to day activities immediately after the procedure.
Sclerotherapy can also be used to treat large varicose veins.
- Radiofrequency Therapy
Radiofrequency Therapy is also a very effective treatment. In this treatment, radiofrequency heat is used instead of laser energy to heat up and make scar tissues to damage the walls inside the veins.
Radiofrequency therapy causes the vein to close and reroute the blood.
Tips for recovering after minimally invasive treatments
Usually, patients can resume their all everyday activities immediately after the procedures as mentioned above, but patients should follow some precautions.
- Avoid strenuous activity for some days
- Wear compression stockings for several weeks or until the treated area healed completely.
- Avoid sitting or standing for an extended period.
- Daily walk for 15-20 minutes.
- Elevate leg for 10 minutes.
- Avoid heavy lifting and strenuous activity for a couple of weeks.
- Avoid swimming and tub baths or hot tub baths for the first week.
- Compression stockings
Before approaching any surgery or treatment, a patient should be compliant with compression stockings.
Compression stockings may not eliminate varicose veins or may be unable to prevent the development of new varicose veins, but they help to reduce inflammation and the overall progression of the disease process. These stockings help to move blood efficiently in the limbs.
Compression stockings put external pressure on the legs to encourage blood flow towards the heart.
These stockings are readily available in pharmaceutical stores.
- Endoscopic vein surgery
When varicose veins reach its advanced stage, it needs surgery to cure. In this procedure, surgeons will make small incisions near the varicose vein, and they will insert a tiny and thin video camera (endoscope) inside the legs to get a proper visual of damaged veins and remove them with small incisions and seal the veins from the inside.
This procedure is performed on an outpatient basis means the patient can go home on the same day of the surgery.
After the surgery, patients can resume their normal activities very soon.
- Vein stripping and ligation
This surgery is to eliminate bulging and twisted veins on the surface of the skin. This procedure is followed by tying the vein before it goes and joins a deep vein. Small cuts help to remove the diseased veins in the skin. In this treatment, surgeons make some small incisions on the skin. One incision will be in the groin region, and others will be on the leg or thigh or ankle. A thin, flexible thread-like wire will be inserted through the groin incision, and it will be tied up with the vein, and the other end of the wire will be pulled out through the cut in the lower leg or ankle.
The surgeon will stitch the incisions and cover it with bandages and after the surgery wearing compression stockings will be recommended.
In today’s times, there are very few indications for doing open surgery like this and we hardly need to do this. The reason for this is that recurrence rates have been found to be higher with open surgery rather than endovascular procedures. Also recovery time is very long for patients who undergo open surgery.
Tips for recovering from post-surgery
- Take rest for at least 5-7 days.
- Wear compression stockings.
- Daily walk for 10-15 minutes.
- Light exercise and stretch.
- Keep the bandage dry.
Some latest treatment options for varicose veins also developed by researchers and doctors.
Here are the three latest treatment
In the year 2013, the FDA approved Varithena treatment. In this procedure, a thick foam will be inserted into the diseased vein and force it to collapse.
This procedure is similar to foam sclerotherapy.
Varithena treatment doesn’t require a hospital stay and the patient can return to his normal activities.
This treatment was approved in the year 2008. In clarivein procedure, the doctor will insert a thin and flexible catheter inside the leg. This is mechanochemical ablation (MOCA). The tip of the catheter has a vibrating instrument which damages the inside lining of the vein (mechanical) and then, the doctor injects the sclerosant (chemical method). This dual-action causes the vein to collapse and get ablated.
The FDA approved Venaseal treatment in the year 2015. In this treatment, adhesive or thick glue will be inserted inside the damaged veins through the catheter.
The adhesive causes the affected veins to close up.
This procedure takes about 30 minutes to complete.
The best thing about these latest treatments is that the complications that we associate with laser and RFA (due to burning of surrounding tissues with heat emitted by laser / RFA) are absent. Ecchymoses (darkening of the skin due to damage to soft tissues), numbness (due to damage to nerves), although are very rare with laser / RFA, are eliminated completely in Varithena, Clarivein and Venaseal.