Overview
Surgery For Varicose Vein
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Typically varicose veins are caused by incompetence of the valves within the superficial veins. As these valves become more incompetent, blood backs up (away from the heart) and causes dilatation of superficial veins. While these veins are not harmful, they may lead to swelling, discoloration, and discomfort in the lower extremities. Varicose veins typically do not respond to injection sclerotherapy or lasers. As they are not terribly dangerous, treatment is reserved for patients that are having symptoms. The most effective therapy for varicose veins is removal. |
Problems Associated With Varicose Veins
Problems can occur if the faulty valves are located within the veins that perforate the calf muscles (deep veins).
Associated problems may include:
- Aching in the legs.
- Skin rashes such as eczema.
- Brownish ‘stains’ on the skin surface, caused by the eruption of capillaries.
- Skin ulcers.
- Blood clots forming within veins (thrombophlebitis).
Common Side Effects Of Surgery
Some of the common side effects of varicose vein surgery include:
- Swelling, which may take a few weeks to subside. The feet and ankles are particularly prone.
- Scarring, although scars tend to be less noticeable than varicose veins and fade with time.
- Brown staining of the skin may occur, but tends to fade with time.
- The skin and calf muscle may be painful, swollen and bruised.
- Unintentional injuries to nerves may cause patches of numbness or ‘pins and needles’.
- These patches may recover in time (up to two years in some cases) or they may be permanent.
Possible Complications Following Surgery
Varicose vein surgery is considered to be safe, but all surgery carries some degree of risk.
Possible complications may include:
- Infection, particularly if skin ulcers were present
- Blood clots forming within deep veins
- Bleeding or bruising.
What Are The Treatments Available For Varicose Veins ?
Sclerotherapy - This is a minimally invasive technique which involves injecting a chemical solution into the affected vein which causes it to shrink and gradually disappear. The procedure may involve 1-50 injections to cause shrinkage of the vein. Then the leg is wrapped in a compression/elastic bandage to ensure that the veins remain closed. No Anesthesia is required in this technique.
Sclerotherapy helps to improve the cosmetic appearance of varicose veins and to relieve pain, burning and aching sensations, swelling and night cramps. It is the most commonly used technique for treating small varicose veins in the legs.
Laser therapy or radiofrequency/Endo-venous ablation of varicose veins- It is an advanced ultrasound guided laser technique that uses radiofrequency or laser energy to produce heat and thereby burn and close abnormally enlarged varicose veins in the legs. This seal off the spider/varicose veins thus diverting the blood flow immediately to nearby healthy veins. The technique is very direct and accurate, and only affects the area being treated.
The procedure involves a small puncture into the skin and so the patient may feel a small pinch, and then the skin is soothed by cooling after the laser is applied. Some redness and swelling may appear but this disappears within a few days. The duration of the treatment is usually 20 to 25 minutes; and two to five sittings are generally needed to remove varicose veins in the legs depending upon their severity and extent. The advantage of Laser therapy is that it is safe for all skin types and colors.
The procedure may be used for both cosmetic purposes and also for reducing symptoms such as pain, swelling, discoloration, inflammation etc.
Surgical procedures- The most common surgical options for the treatment of varicose veins are surgical stripping and ligation.
Surgical stripping and ligation is used in most severe cases that take account of only 8- 10% of talengectasia cases. The procedure is employed to remove Long saphenous vein (the largest main superficial vein) which runs from the groin to the ankle. The vein collects blood only from the skin surface. Incisions are done down into the leg and locate underlying diseased veins and then Long "strippers" of various designs are passed through these deeper veins and then the stripper and vein are pulled out of the leg together.
The surgeries usually done are:
- Mini-phlebectomy,done under local anesthesia and is used to remove the faulty area of a vein through minute incisions.
- Ambulatory surgery for removal of the long saphenous vein by making small incisions made along the course of the vein and removing it by small surgical hooks
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Varicose Veins 
Radiofrequency Occlusion
Sclerotherapy
Vein Stripping 
Lower Leg Ulcers 
Vascular Malformations 
