Modern methods of treating varicose veins of the legs

Treatment of varicose veins of the legsIt is a difficult task for both the doctor-Photologist and the patient himself.This is due to different forms and stages of the disease, requiring significantly different therapeutic measures.An important role is played by the principle of minimal injury and the fastest rehabilitation of the patient.Effective and, at the same time, sparing therapeutic procedures are high-tech and require modern medical equipment and qualified specialists-Photobologist.

Ways to treat varicose veins:

• Conservative events
• Sclerotherapy
• Surgical methods

Almost always, treatment methods are used together, successfully combined and complement each other.

Conservative treatment of varicose veins.

This is a set of measures aimed at reducing the risk of complications of Varicosity and improving the quality of life of the patient.This method does not eliminate varicose veins and therefore requires constant use.

• Correction of lifestyle-measures aimed at training the so-called muscle-venous pump.The muscle-venous pump is a kind of pump that provides an outflow of venous blood from the lower extremities.The functioning of such a pump is possible thanks to the joint work of muscles and veins of the legs.With muscle contraction, veins are compressed, passing between and inside the muscles, so the blood moves towards the heart.Training includes various exercises, dynamic sports loads.Swimming, classes on an exercise bike, Scandinavian walking, running skiing are very useful. It is necessary to exclude long static legs.To improve the venous outflow, the so -called pastoral drainage is useful during the day, that is, the adoption of the pose in which the legs are in an elevated position, which contributes to venous outflow.For example, the semblance of a “pose of cowboy” - when a person sitting on a chair puts his legs on the table.Respiratory gymnastics is useful, because proper deep breathing stimulates the venous flow of blood.It is recommended to exclude overheating of the body, since the tone of the veins falls significantly.The venous stagnation arising from this is a factor that damages the wall of the veins.

• DietIt is an important component of therapy.Food should contain a sufficient amount of vitamins and trace elements.Proper nutrition contributes to regular physiological departures.In the absence of constipation and frequent swelling of the abdomen, a normal outflow of venous blood from the lower extremities remains, and the likelihood of varicose veins is reduced.
• Compression therapyIt includes the use of various bandages, bandages, knitwear, mechanical devices.On the surface of the legs, a pressure is created, which is transmitted to deeply located tissues and has a therapeutic or preventive effect.

The main value in compressive is currentlyMedical compression knitwear.Elastic binting of the legs is now used much less often.The advantages of compression knitted products over bandages are obvious: the simplicity and ease of putting on while maintaining the necessary and physiologically dosed pressure.Binting of the legs is used in special cases: in a special shape of the legs, in cases of a complex course of venous trophic ulcers, at certain stages of Varicosity surgical treatment.Proper bandaging is a complex process performed only under the supervision of a doctor.

The selection of the type, form and class of knitwear should be carried out by a specialist.This is due to the fact that there are certain contraindications for wearing compression medical devices.For example:

• Severe cardiopulmonary failure is a contraindication for legs compression.
• The greatest efficiency of a particular product in a particular patient is important.
• In the treatment of chronic diseases of the veins, in particular the advanced cases of varicose veins, which are accompanied by significant venous edema, the so -called compression variable, created using the dynamic Pneumocompression apparatus.
• In drug treatment of varicose diseaseThe so -called phlebotropic drugs (synonyms are the main importance of the active drugs, Phleboprotector).This is a large group of drugs that can reduce the severity of chronic venous edema and other manifestations of chronic veins.Unfortunately, Phlebotropic drugs do not restore VaricOSITY changed veins.Medicines from this group are prescribed in the form of courses for 2-4 months.These funds are effective only when oral administration.
• The most effective method of physiotherapy varicose veins isElectric muscle stimulation of the lower extremities.This method can be used when drugs and compression knitwear are contraindicated for various reasons.Like other conservative measures, this method does not eliminate varicose veins, but reduces the manifestations of concomitant venous insufficiency.There are modern individual portable devices for independent electrical stimulation.

Sclerotherapy

Sclerotherapy - the main method without survey treatment Varicosity.The essence of the method is very simple: a special drug is introduced into Varicose through the syringe, and compression is applied to the feet.As a result, the closing (occlusion) of the diseased area of the vessel occurs.In the future, varicose vein completely disappears.Blood moves through healthy veins, blood circulation in the leg improves.At the same time, not only expanded veins disappear, but also the clinical manifestations of the disease - pain, swelling, cramps, severity in the legs.The procedure for a long time, and often for life, guarantees a good treatment and cosmetic result.Low cost, minimal risk of injury, a combination of a good functional result with a high cosmetic effect are the distinctive features of this method.

Modernsclerotherapy large varicose veinsAnd the trunks of subcutaneous veins are carried out by a foamed form under the control of an ultrasound scanner-micro-foam (foam-form) echo-sclerotherapy.Micro sclerotherapy “vascular stars” is performed under the control of a special apparatus - Transilluminator.

Sclerotherapy as an independent therapeutic procedure is performed with:

• insulated varicose expansion of subcutaneous veins;
• reticular varicosity ("vascular grid");
• Tulangiectasia.

In a number of patients, in order to reduce the operating injury and increase the cosmetic result, Sclerosis is carried out after a certain time after surgical intervention.PHLEBOSCLEROTICUsed to treat relapse Varicosity in order to stop and prevent bleeding from varicose veins, as well as in some forms of congenital angiodysplasia.

Contraindications for the use of Sclerotherapy:

• Severe systemic diseases (heart or pulmonary failure, liver failure, etc.)
• Thrombophlebitises
• Local or general infection
• The need to comply with bed rest
• Expressed allergic manifestations
• Pregnancy and breastfeeding period
• Conditions in which compression therapy of the legs is contraindicated

Surgical methods of treating varicose veins

Surgical interventions with varicose veinsThe legs are the most radical treatment method.The vast majority of modern transactions can be performed on an outpatient basis or in surgical hospitals of one -day stay.

Scientific and technological progress caused revolutionary changes in the treatment of varicose veins of the lower extremities.After the introduction of high -energy lasers into the clinical practice of Phlebologists,Endovasal Laser Obliteration (ELO)It has become a little invasive treatment of Varicosity.The essence of ELO is the destruction of varicose veins with a laser beam.This technique is not an operation in the traditional sense.Not required incisions, all manipulations are carried out through micro punctures.The intervention is performed on an outpatient basis under local anesthesia and hospitalization in the hospital does not require.All manipulations are carried out under visual ultrasound control.Through a small puncture in the lower thigh or upper leg of the lower leg, a thin flexible laser light is introduced into the vein.After that, a solution of anesthetic for pain relief is administered around the vein.In the operating mode, strictly dosed thermal energy is supplied through the Svetovod, which causes complete closure (occlusion) and further prison (“overgrowing”).

The patient retains a fairly active daily routine with minimal discomfort.ELO in terms of efficiency and at the same time the smallest chance of injury significantly exceeds the existing methods of classical operations.

There are restrictions for ELO use:

• Extremely neglected Varicosity with a significant expansion and curved main subcutaneous veins.In such cases, combined Phleubectomy is shown.
• Repeated interventions on subcutaneous veins.In these cases, the possibility of using ELO is specified individually in each patient with in -depth examination.

Large Varicosity expanded trunk trunk tributaries are currently removed using such a sparing procedure asOutpatient mini Phleubectomy.This intervention is performed under local anesthesia with special tools through micro -skin micro.As a rule, it is performed immediately after ELO or used as an independent method.Hospitalization in a hospital and anesthesia is not required.Pain and discomfort in the postoperative period are minimal.With large varicose veins, a cosmetic result is often higher than with sclerotherapies.

Classic operations

Classic operations are shown in casesvast neglected varicose lesion.As a rule, hospitalization is required in a specialized hospital of vascular surgery.Interventions are performed using anesthesiological manuals - anesthesia or regional (spinal) anesthesia.Such operations include combined Phleubectomy, Endosurgical dissection of perforant veins.This group of operations has a long period of rehabilitation, often unsatisfactory cosmetic result.Often there are complications in the form of Thrombophlebitises, damage to healthy tissues, nerves, early relapses of Varicosity.

In conclusion, it must be said that, despitea complex integrated approach in the treatment of varicose veins,This pathology is successfully treated at present.