Leg Vein Removal Surgery For Varicose Veins Or Laser Removal? What is better

Varicose veins are a disease characterized by a change in the condition of the veins in the legs with impaired blood flow. When the form is neglected, the vessels swell, which leads to swelling and soreness of the limbs (under load), as well as aesthetic concerns. For this stage, surgical removal of damaged veins is effective.

Indications for varicose vein surgery

Varicose vein surgery can only be performed if there are indications for vascular removal:

• varicose veins have affected most of the vein;
• severe soreness and swelling of the legs during physical exertion, which interfere with a normal lifestyle;
• formation of open wounds and ulcers in the background of the development of the disease. Dangerous it is dangerous to attach a secondary infection;
• violation of blood permeability through vessels, often accompanied by convulsions;
• marked development of vascular necrosis;
• pathological changes in the veins, accompanied by their expansion and elongation. The change is dangerous from trauma to the vessels, and also causes aesthetic discomfort;
• blood clots in the veins.

Surgical intervention is permissible only with advanced forms of varicose veins and in the absence of dynamics with conservative treatment.

Absolute and relative contraindications for surgery

Varicose vein surgery for varicose veins is performed not only if there are indications, but also in the absence of contraindications:

Absolute bans on surgery	List of relative stops
Stable high blood pressure	Presence of infectious diseases
Regular jumps in blood pressure index	Dermatological pathologies affecting the skin on the feet
Chronic heart disease	Inflammatory processes in the body, including blood vessels
Advanced age after 70	Recovery period after other surgical interventions
Presence of cancers	Chemotherapy
Diabetes mellitus and severe asthma	Severe soft tissue injury from trauma
Thinning and fragility of blood vessels	Acute liver and kidney pathologies
Patients with limited mobility of the legs (paralysis) or patients lying in bed	Blood clotting disorder or anemia
Varicose veins in the final stage	Taking hormones, antibiotics or other harsh medicines
Presence of complex leg fractures (with damage to blood vessels and nerve endings)	Being overweight
Allergic reaction to medications used during surgery	Refusal of the patient from surgery

When carrying a baby, there may also be a violation of the condition of the veins in the legs. Most often, the pathology is eliminated on its own after birth. In the presence of contraindications, surgical intervention is dangerous with a deterioration of the patient's condition and even with a fatal outcome.

Phlebectomy

Phlebectomy is a surgical procedure to remove damaged veins and restore normal blood flow to the deep veins.

Anatomical understanding, technique of major operation to remove veins

The circulatory system of the foot consists of a deep vein and many branches of the superficial veins, which affect the varicose veins. Changes in vascular activity develop due to valve dysfunction. During normal operation of the vessels, the valves are closed, which ensures blood flow in only one direction.

In the veins of those affected by varicose veins, the valves do not close, as a result, blood can move in both directions, leading to impaired blood flow, with blood clots and varicose veins.

To restore blood supply to the limb, it is necessary to eliminate the affected vein (with reverse blood flow), ie perform a phlebectomy. Before surgery, the patient undergoes preparation (taking tests, scanning the condition of the veins, determining the general condition of the patient).

If there are no contraindications, specialists perform a surgical procedure, which consists of the following stages:

1. Provides access to the affected vessel through a small incision (in the groin or popliteal, depending on the location of the vein). Next, the damaged vessel is connected by a deep vein to block blood flow.
2. An incision is made near the varicose vein. Using a probe, a vessel is separated from muscle tissue, the lymphatic system, and small capillaries. Through a tube, or using a blow, the damaged vein is removed.
3. Capillaries are treated to prevent bleeding.
4. If there are damaged capillaries that form spider veins, they are removed.
5. Finally, cosmetic sutures, a disinfectant dressing and an elastic bandage are placed.

The operation is performed under general or local anesthesia. It depends on the size of the ship and its location.

Efficiency level

Surgical removal of veins is used at different stages of the development of varicose veins. The procedure is very effective (over 98%). Restoration of blood circulation occurs in a short time.

Rehabilitation

The effectiveness of the procedure depends not only on the qualifications of the surgeon, but also on compliance with the rules in the postoperative period.

After phlebectomy, you need:

• suture care for 7-14 days in a hospital;
• wearing compression stockings or elastic bandages for 30 days is performed all the time;
• after 30 days, for another 3 months, wearing specialized underwear during the day
• water procedures with foot washing (where the operation was performed) are possible only after removing the sutures;
• saunas, baths and hot tubs are prohibited;
• Postoperative pain medication is prescribed by a doctor. Self-selection is prohibited;
• take extra medicine to prevent blood clots;
• taking medicines to strengthen the walls of blood vessels (vitamins E and C);
• it is forbidden to stand in a standing / sitting position for a long time, wearing high-heeled shoes and tight underwear;
• During the rest period in the supine position, the legs should be above body level. Promotes the outflow of excess blood and reduces swelling;
• Introduce timely and gradual physical activity to normalize blood flow (discuss with your doctor);
• massages and physiotherapy are performed with the permission of the participating specialist;
• rejection of alcoholic beverages and nicotine. Alcohol provokes vasodilation, and smoking, on the contrary, leads to their narrowing. These effects reduce the efficiency of the operation;
• if you are overweight, a low calorie diet is prescribed.

If the rules are followed, full restoration of limb function is possible in 6 months.

Endovenous coagulation using a laser

An operation to remove leg veins with varicose veins using a laser is performed when direct vessels with a diameter of at least 0. 02 cm and a small number of capillaries are touched. The procedure consists in the action of light waves on the damaged vessels with their subsequent union and destruction.

Equipment

Laser vein coagulation can be performed with any of the 3 types of fiber optics:

Type of fiber optics	Brief Brief of Action
End (classic)	This fiber produces beam radiation from the bottom, i. e. the container is sealed in front of it. Evil is the formation of hematomas and a painful feeling of tightness of the veins. Maximum vein diameter 0, 1 cm.
Radial (with painless radial light guide elves)	Light waves from the fiber form a circle that wraps around a vein in diameter. This allows veins of any size to be treated. And also the risk of hematoma formation and swelling development is minimized.
Of 3 types of radial fibers	Lasers with two light rings are used to eliminate varicose veins. The first prepares the vein for the procedure (eliminating excess fluid), the second circle joins the walls. For treatment, light guides are produced for thin and short veins and for large vessels.

The choice of equipment is made not only by the patient, but also by the specialist who participates in the condition of the vessels.

Which veins can be removed with the EVLK method

Before choosing EVLK from a phlebologist (a specialist who examines veins and eliminates varicose veins), the characteristics of the damaged vessels are determined. They must be straight and at least 2 mm in diameter.

As a result, laser therapy can be applied to the following groups of vessels:

• small and large saphenous veins;
• safene accessory veins, which are at least 5 mm from the surface of the epidermis;
• vessels that connect deep veins with superficial ones.

For other veins, therapy is only possible with phlebectomy.

Efficiency

Vein removal with EVLK method is possible with 3 types of optical fibers. Depending on the type of equipment, the effectiveness of the treatment varies. When performing an operation using an end light guide, the effectiveness of the therapy is 94-96%. Radial light guide surgery allows you to achieve 100% results in eliminating varicose veins in the legs.

Stages of preparation and implementation

When choosing to remove varicose veins using EVLK, the patient should undergo the following training:

• Cancel hormonal medications (if taken). Since they can cause the development of thrombosis;
• the day before the intervention, blood thinners are required;
• examination of damaged veins to determine the extent of their damage;
• taking tests to rule out the presence of a latent infection or inflammatory process in the body. Blood clotting is also determined;
• the procedure site is thoroughly washed and shaved (without the use of cosmetics, only antibacterial soap is allowed).

Before starting the operation, mark the borders of the damaged vessels, the place of laser / fiber insertion and the location of the branched capillaries. These marks allow you to connect the beginning and end of the vein as well as the capillary outlets. The process is performed under the control of an ultrasound machine.

EVLK is produced in stages:

1. Insert the catheter through a small puncture (the catheter insertion site is anesthetized with local anesthesia) in the marked area. The light guide will move along it.
2. Inserting the light guide into the catheter and its subsequent progression to the damaged area. Performed under ultrasound control on a monitor.
3. Injection of anesthetic to numb the vein and adjacent tissues.
4. Advancement of the "active" light guide through the damaged vein, followed by a delay at the sites where the capillaries branch (to close the outlets and prevent bleeding).
5. Laser removal with antiseptic treatment of the drilling site and use of an elastic bandage (or use of compression stockings).

Upon completion of the procedure, the patient can be discharged from the hospital immediately.

Characteristics of rehabilitation

To restore the functioning of the damaged limb and to prevent the development of complications, you should be familiar with the nuances of rehabilitation after EVLK.

Are:

• after the procedure, it is recommended to walk the operated leg in a medical institution for one hour;
• for 2-3 days, ultrasound examination of the treated vein is performed;
• for 5 days, you should wear specialized underwear all the time (the type of socks is discussed with the specialist who participates before the operation). Then, within 45-60 days, the clothes should be used during the day;
• knead your feet daily, walking every day for 60 minutes;
• avoid overloading the leg (extended sitting or standing position) and visiting the sauna or taking a hot bath.

If the removal of varicose veins is still required, the procedures are allowed to be performed no earlier than in 7 days.

Advantages of each method

Varicose vein surgery for varicose veins, depending on the type of intervention, has the following advantages:

Flebektomia	EVLK
The incisions for the operation are about 5 mm, so there are hardly any scars left	No pain during the procedure (using local anesthesia). General anesthesia is not required
Painless after surgery performed under local anesthesia. For miniflebectomy, local anesthesia is used.	EVLK is performed under ultrasound control. The result is high accuracy and efficiency.
Low cost	Hematomas and pain at the site of surgery are rare or mild.
Rapid restoration of skin tone (absence of stars and purple-cyanotic shade of epidermis)	The operation requires 1 puncture, so no sutures or wounds are required
Short recovery period of about 30 days	Recovery period up to 5 days
Effective for all forms of varicose veins	After surgery, the patient can leave the clinic within 1 hour.
Return to normal life is possible in 24 hours.
EVLK can be performed when the integrity of the epidermis is compromised by the ulcer.
The duration of the surgery is no more than 40 minutes.
EVLK can be performed on both feet in one day. On one leg, a second operation is permissible after 7 days.

The risk of infection during the procedure is minimal, as the cut / puncture is small.

Complications after surgery and laser veins

There is a risk of complications after vein removal by surgery or laser. Adverse reactions may occur due to the low qualifications of a specialist or due to rule violations during the rehabilitation period. Possible complications of phlebectomy and endovenous coagulation.

Vein Removal Methods	Minor complications from procedures	Big Complications
Phlebectomy	hematoma and minor bleeding; temperature rise; swelling of the limb due to a temporary disruption of the lymphatic system, as well as if the rules of rehabilitation are not followed; pain, decreased sensitivity in the area of ​​surgery; formation of seals due to small hemorrhages under the skin from the capillaries of the removed vein; rushing of layers due to improper processing; nausea after general anesthesia.	development of deep vein thrombosis (therefore, during the recovery period, it is required to take blood thinners and follow the diet prescribed by the doctor); tissue numbness in the operated area. Probably if nerve endings are damaged during surgery; Inflammation of a deep vein as a result of infection during surgery or in violation of care rules.
Endovenous laser coagulation	hematomas when using a spotlight guide; swelling within 3 days; a feeling of muscle tension and soreness at the site of the removed vein, especially when the leg moves; slight rise in temperature; appearance of seals at the site of the removed vein due to blood rushing to the "closed area"; with insufficient fusion of the walls of the damaged vessel, it is possible to restore blood flow in it and the progression of varicose veins. Repeated surgery required; change in epidermal tone during the period of "closed vein decomposition". Provided the container is located close to the surface of the skin.	formation of blood clots in deep veins; the laser burns in nearby tissues and nerve endings with subsequent disruption of limb function; development of the inflammatory process when an infection enters the puncture site; spraying and gluing a portion of the fibers into the vein to be operated on. Occurs extremely rarely when using low quality equipment.

During both surgeries, an allergic reaction to anesthetic drugs may develop.

Measures to minimize complications

Surgery to remove leg veins with varicose veins is sometimes associated with the development of complications, to prevent their occurrence is required:

• testing for allergic reactions to medications used;
• exclusion of infectious diseases and inflammatory processes in the body before surgery;
• selection of proven clinics with highly qualified specialists and modern equipment;
• compliance with the rules during the recovery period. Especially wearing compression underwear;
• observe diet food during the recovery period (discussed by a specialist after the procedure). The amount of pure water in the diet increases, food intake is done in small portions, the diet is enriched with vitamins and minerals;
• resting legs during working hours;
• undergoes a postoperative examination to follow the dynamics of limb recovery;
• to perform massages and follow physiotherapy procedures to quickly restore blood flow.

If any deviation is found to be unacceptable for this operation, you should contact the clinic immediately.

Comparing forecasts

With both methods of removing leg veins, the probability of complete cure is higher than 95%, but depending on the exclusion of contraindications, adherence to the rules during the rehabilitation period and choosing a proven clinic. With surgical treatment, blood flow and the external condition of the legs are restored after 3 months, and with laser therapy, healing is noted after 30 days.

In advanced forms, removal of blood vessels is performed with surgical intervention. The method of treatment is determined not only by the desire of the patient, but also by the presence of indications and contraindications of the procedure. The effectiveness of therapy depends on the qualifications of the doctor and the application of the rules of foot care after surgery.