Modern vein treatment – an overview
Although venous disorders are not entirely curable, various treatments are nevertheless available. Basic therapy involves medical compression stockings: Their precisely defined pressure distribution mechanically counteracts poorly closing venous valves to prevent the blood from pooling in the legs.
More about compression therapy
Vein surgery: examples of different surgical methods
For advanced venous insufficiency with the formation of varicose veins (varices), the doctor may recommend vein surgery. Before each vein surgery, an examination is performed, by ultrasound (Doppler ultrasound) for example, to determine the extent of the vascular disease. Based on the individual findings, after discussion with the patient the doctor will decide on the most suitable method of therapy.
Follow-up treatment for vein surgery
The vein surgery aftercare always includes a check-up by the physician. The patient is usually fitted with medical compression stockings. The duration of medical compression therapy depends on the surgical method used, its side effects and the individual healing process.
Note: Vein surgery alone cannot cure vein weakness. Patients should thus continue wearing medical compression stockings every day even following successful vein surgery in order to benefit from the results of the operation for as long as possible.
Vein stripping – pulling out the diseased veins
Vein stripping is performed under either local or general anaesthesia. The affected veins of the superficial venous system are first clamped and then pulled out (stripped) through small incisions in the skin.
Vein stripping procedure
The truncal vein is first exposed through a small incision in the groin.
Any side vessels that open into the vein are then closed off and the large vein itself is tied off to ensure that blood can no longer flow through it.
The surgeon makes the second incision below the diseased section of vein, ties it off there and severs the vein. The probe is used to pull out the diseased section of the vein.
Following surgery, the incisions are closed and the leg is wrapped tightly with a compression bandage.
Sclerotherapy: gentle procedure to close the veins from the inside
In sclerotherapy, a special sclerosant is injected into the diseased veins. This results in occlusion and subsequent sclerosis of the affected vessels. The body eventually transforms the sclerosed vessels into connective tissue.
Foam sclerotherapy is mainly used to treat larger veins, such as the large truncal vein. The sclerosant is foamed just before it is injected into the vein. The foam’s large surface area ensures that all areas of the veins are optimally reached.
Chiva method: surgical ligation of diseased veins
The Chiva method was developed in the 1980s as an alternative to pulling out varicose veins: following the ultrasound examination, the surgeon decides where to ligate the veins. Small incisions are made there, the varicose veins are pulled out, tied off with a suture and severed. As most incisions are very small, they only need to be closed with a butterfly bandage and do not require sutures. The treated vein is gradually absorbed by the body in this case too.
Laser treatment for veins: laser seals off diseased veins
Laser therapy is a gentle procedure for treating varicose veins. No skin incisions are required, only a puncture comparable to taking a blood sample. The affected truncal vein is punctured with a hypodermic needle above the knee or at the ankle under ultrasound control. The attending physician inserts a catheter equipped with light-conducting laser fibres at the tip into the vein and up to the beginning of the diseased section. The laser energy emitted from the fibres cauterises the veins from the inside. The entire diseased section of the vein is treated in this way as the catheter is withdrawn. The vein is sealed off, thus preventing blood from flowing back. Patients feel no pain other than a slight sensation of warmth. The vein is then gradually absorbed by the body.
Radio wave therapy: closure of diseased veins through heating
This procedure is comparable to laser therapy. What differs is the type of heat applied: in place of light energy, radio waves are used. Radio wave therapy, also referred to as the radiofrequency procedure, is a minimally invasive method in which the affected vein is punctured and the radiofrequency catheter is inserted into the diseased vein. To induce local anaesthesia and protect the surrounding tissue, the physician injects a diluted anaesthetic into the subcutaneous fat tissue around the diseased vein.
Heat is transferred to the vein wall through a probe, causing it to shrink, close and eventually be absorbed or converted into fibrotic tissue by the body.
Treatment support with exercise and medication
Medical compression stockings are the basic therapy for dilated veins and weak vein walls that do not close off completely. Exercise, alternating cold and hot baths and medication can be used to support this therapy.
Tablets and ointments: an error often due to misleading advertising!
Although people with venous disorders often resort to ointments and tablets recommended by the media, damaged vein walls and valves cannot be healed in this way: ointments and medicines can at most supplement the therapy. The basic therapy for venous disorders is wearing medical compression stockings that have a scientifically proven positive effect on venous disorders thanks to the mechanical pressure they exert!
Herbal extracts such as horse chestnut, for example in tablets or ointments, can only support the therapy.
Exercise to activate the calf muscle pump
- Avoid long periods of standing and sitting.
- Do vein exercises several times a day, especially if your work requires prolonged standing or sitting.
- Activate the calf muscle pump with walking and sports, as this gets the blood flowing.
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