Removal of varicose veins - types of surgery and contraindications

Conservative therapy for varicose veins is practiced only at the beginning of the development of the pathology. Surgery for varicose veins, especially at an advanced stage, becomes the only cure.

Indications for an operation

For severe varicose veins of the lower extremities, the operation becomes a forced procedure. The indications are:

  • advanced degree of the disease;
  • significant increase in veins;
  • violation of venous blood flow;
  • severe pain in the affected limb, feeling of heaviness;
  • the formation of trophic ulcers;
  • Development and exacerbation of thrombophlebitis.

The indications also include fatigue, when a person cannot stay on their feet for a long time.

Surgery to remove varicose veins

Limitations and contraindications

Surgical therapy for varicose veins has its own contraindications. There are certain prohibitions on surgical interventions.

You cannot operate on a person in the following cases:

  • diagnosed hypertension;
  • late stage of varicose veins;
  • existing (confirmed) coronary artery disease;
  • the period of development of infectious pathologies;
  • advanced age of the patient;
  • Erysipelas of the skin, eczema and other skin diseases;
  • the second is the third trimester of pregnancy.

Oncopathology and chemotherapy are contraindications.

Surgical methods

Surgical treatment is carried out in several ways. Vascular surgeons use the following techniques:

  1. Phlebectomy.
  2. Laser correction.
  3. Sclerotherapy.

Phlebectomy is popular

Phlebectomy is one of the ways to treat the advanced form of varicose veins. The combined technique is the most widely practiced. It consists of several phases, each of which is a separate process:

  1. Crossectomy- Ligation of the great saphenous vein and the adjacent ducts. The technique prevents blood backflow and also prevents the outflow of blood from deep veins into superficial ones. The narrowing of the duct veins is used to prevent recurrence. If this is an independent operation, a drain is installed in the wound and sutured.
  2. Safenectomy- Ligation of all ducts in front of the mouth in the groin area. The vein is cut at the beginning - in the ankle area.
  3. Stripping. . . During the operation, part of the vein that has varicose veins is removed. Duplex scanning is used to determine the exact area.
  4. Miniflebectomy. . . Gentle surgical intervention. Inflamed areas of the vein are removed by puncturing the skin. It is done under local anesthesia. The rehabilitation period is short.

The final stage of the combined phlebectomy is the suture.

Phlebectomy for varicose veins

Sclerotherapy - painless removal of varicose veins

Sclerotherapy is a non-invasive procedure that involves injecting a special drug, sclerosant, into the lumen of the damaged vessel. Its active substance are molecules that destroy cell membranes. After the active ingredient gets into the vein, the damaged area of the vessel is glued together. This causes the varicose vein to fill with connective tissue and stop functioning.

Sclerotherapy is divided into several types:

  • Microsclerosis. . . Microsclerotherapy is practiced at the initial stage of varicose veins - the appearance of spider veins.
  • Echosclerosis. . . The technique is used when large-volume varicose veins are formed or when a sclerosant must be injected into deep veins. It is carried out under the control of duplex scanning.
  • Foam sclerotherapy. . . Allows the use of modern sclerosants, which turn into foam on contact with air. The effectiveness of the technique relies on better contact of the drug with the internal surfaces of the veins. The variety is practiced in treating varicose veins of large blood vessels.

Important! The patient must be observed by a phlebologist for the next 6 months.

The results of the treatment are not immediately visible. The maximum term is 2 months. The sclerotherapy procedure helps get rid of the external manifestations of varicose veins - asterisks and vascular networks. The technique allows you to improve local blood circulation, which will make pain, swelling and fatigue go away.

Sclerotherapy of varicose veins

Lasers in phlebology

Laser therapy in phlebology has several names:

  1. Endovascular laser coagulation (EVLK);
  2. Endovenous laser obliteration;
  3. Endovenous laser ablation.

During the procedure, the surgeon punctures the inflamed vein. A laser light emitting diode is then inserted into it, through which a medical laser shines. The diseased vessel is closed.

Recommendations for EVLK - Damage to one or more large veins. If small branches are affected by varicose veins, the technique is not used. A contraindication is the patient's tendency to form blood clots.

The advantages of the laser process include:

  • inflamed veins do not need to be removed;
  • no special training required;
  • Lack of anesthesia;
  • short rehabilitation period;
  • Absence of pain syndrome;
  • Sealing only the damaged vein area;
  • Maintaining the patient's ability to work.

A recurrence of varicose veins after laser therapy is completely excluded.

Among the disadvantages and complications, it is worth highlighting the following:

  • Prosthetics is a short-term loss of feeling in the operated extremity. Occurs in approx. 40% of all laser applications.
  • Infection and blood clots. An undesirable result of the operation can be the development of superficial thrombophlebitis.
  • Postoperative bleeding. Developed as a result of thermal / mechanical exposure to surgical equipment, in rare cases, a hematoma forms that resolves on its own within a month.
  • Ecchymosis. During rehabilitation, pigmented areas can develop in the operated area. You go on by yourself.
  • Induction - small lumps in the operated area. They are found in almost all patients. They resolve on their own in the first postoperative month without additional treatment.
  • Pain syndrome. About 6% of all patients who have had laser therapy experience mild pain. To eliminate pain, the use of analgesics is recommended.

The reason for such complications is the insufficient qualification of the surgeon.

Laser treatment of varicose veins

Possible consequences

Surgery for the treatment of varicose veins almost always proceeds without the development of serious complications. The patient can go home in a few hours as he does not need a hospital stay.

Even so, the development of certain complications is not excluded. Most often, patients have the following:

  • Bruising. Hematomas can remain visible for up to a month. They resolve on their own without drug treatment. Sometimes bruises persist for 2 to 4 months.
  • Seals the skin. Formed in the area of skin cuts / punctures. They resolve on their own in the first postoperative month.
  • Pain. Painful sensations arise in response to damage to nerve endings. What should be done in this case? Doctors recommend taking pain relievers to relieve discomfort. The condition does not require special treatment.
  • Swelling. Swelling in the operated area occurs with considerable physical exertion. To avoid the development of complications, it is necessary to temporarily give up hard work completely.

Thromboembolic complications are very dangerous

One of the most serious complications is thromboembolism. The pathology manifests itself in the form of deep vein thrombosis and subsequent soft tissue infection.

Primary prevention measures for the development of thromboembolism include:

  • Mandatory bandaging of the operated limbs with elastic bandages or wearing compression stockings.
  • The patient, with its gradual increase, receives allowable physical activity (depending on the condition).
  • Attending therapeutic gymnastics courses.
  • Use of anticoagulants - medicines that prevent blood clots from forming by thinning the blood, as prescribed by your doctor.
  • Use kava filters.

Rehabilitation after surgery

During the recovery period, it is necessary to strictly follow all the recommendations of the attending physician.

  • It is imperative to wear elastic bandages, which will provide the necessary compression, prevent the development of complications and aid recovery from surgery. The doctor will tell you how long the bandaging should last. This is usually two weeks postoperatively.
  • It is recommended to take drugs from the group of venotonics. The duration of treatment depends on the patient's condition.

Important! After performing surgery on the operated limb, it is necessary to ensure complete rest. Strict bed rest is recommended for the patient for the first 24 hours. You must start walking the next day after applying a compression bandage. But you shouldn't overload the leg too much.

During the adjustment period, it is recommended to perform physical therapy exercises to restore the sensitivity and trophism of the tissues. Massage sessions have a beneficial effect. This will help increase both local and general blood flow and prevent blood clots from forming.

Removal of veins with varicose veins is a serious surgical intervention that has its own indications and contraindications. The surgical technique depends on the age of the patient and the current stage of the disease.