What a difficult it is to persuade their parents or elderly relatives seeking treatment for varicose veins? Despite the swelling, pain in the legs and bulging veins, they refuse to go to the doctor. The arguments are the same: "I do not want to be cut. At my age, afraid to go to surgery, he suddenly could not bear anesthesia? Years are not the same, the seams will not heal. Let the young are treated, and we really like something like this … "
Is there an alternative to a major operation? Why can not delay treatment of varicose veins? How to return the tripping of fifty, and even at seventy years? This is We spoke with Fedorov, Dmitry Medvedev — a medical phlebologist, PhD, head of surgical department of the clinic "medical facility on Vein ".
— My mother is a woman of many things modern, drives a car, read the news online, but for the health — it is a terrible conservative. Believes that the bulging veins in the legs and aching pain in the late afternoon — it is a natural sign of age.
It is not right. Varices — a disease that can and should be treated. Want to know what's going on with the veins of your mother?
— Yes, of course.
In your mom's veins widened and lost tone. The normal size large saphenous vein — about 3 mm, it expands varices 1-1.5 cm This causes that the flaps no longer occlude the venous valves.
— Is that bad?
Not a word. The fact that veins are not muscular wall. Unlike the arteries veins do not pulsate. The blood on them moving due to the fact that the veins are equipped with valves. These valves prevent backflow of blood, respectively, support the normal venous blood flow — from the bottom up, from the legs to the heart.
In varicose veins leaflets stop interlock. Gradually there regurgitation and venous stasis. If bad blood flows away — breaks down food tissues. This gives rise to fatigue, swelling, discomfort, pain, etc.
— Yes, my mother sometimes it complains …
The situation is gradually progressing. Of small varicose veins moves to larger, gradually reaching the saphenofemoral fistula — a place where the saphenous veins empty into the deep venous system. Why is the normal operation of saphenofemoral fistula in the groin area? In this region, the two systems (superficial and deep veins) are combined, and venous blood flow within a single unit. While the valve unit between surface and deep veins in the groin area is working well, surgery is not needed, enough sclerotherapy — injections of the drug, adhesive damaged veins.
— And if the valve apparatus saphenofemoral anastomosis damaged varicose veins?
Once the valve unit is destroyed, the pressure of the deep veins spread to the surface. As a result, the blood from the superficial veins begins to flow away very bad and the so-called abnormal venous reset — the blood in the deep veins flows away from the bottom up, comes to the saphenofemoral anastomosis, and then, instead of having to climb up to the heart, dropped back down on the surface veins.
— Sounds scary …
Clinically, the destruction of valvular saphenofemoral anastomosis in the groin area shows sharp progression of varicose veins. Patients say until when varices them much discomfort did not deliver, and then suddenly started deteriorating.
— In this case, the injections will not help?
If the valves are destroyed saphenofemoral anastomosis, and there was abnormal venous reset, high pressure of the deep veins of the superficial veins spread to — they can not be glued together using skleroterepii, and if you still stick together, that they will soon re-open. Therefore, such patients are required to carry out a particular surgery.
— Dmitry Anatolyevich, it turns out that in this case, can not do without the surgery?
To find the appropriate method of treatment of varicose veins, the doctor must first assess the condition of the walls of the veins and the work of the valve apparatus. Appearance does not always correspond to the internal changes, so during the first consultation, which holds phlebologist all patients were mandatory ultrasound of the veins.
— My mother was very afraid of operations …
I understand why she is afraid. Twenty years ago to fight in varicose veins used only flebetomiyu — the operation in which the surgeon pulls the expanded vein through an incision in the leg. Now it is done very rarely, preferring a more effective and less traumatic for patients technique. I am referring to the specialized agencies for the treatment of veins, because in ordinary urban hospitals still do it all phlebectomy.
Because only in institutions have high-tech equipment, trained staff to work on it, and there is interest in the comfort of patients during treatment. Of course, we also can do a phlebectomy, if required by the patient indications, but there is a need for approximately 1% of all cases. The remaining 99% is held more gentle treatment.
— Dmitry Anatolyevich, tell me more about the gentle treatment.
The essence of any treatment for varicose veins is that varicose veins are altered to be removed. Unfortunately, back in the healthy they will not ever become that whatever we do.
Methods gentle removal of varicose veins today there are many — mechanical, chemical, thermal and … Basic is currently the most advanced method of treating varicose veins — it Endovasal laser photocoagulation. That is brewing inside the veins with a laser beam.
— The laser is administered directly into the vein?
Made a small incision, a catheter is installed, it is carried by the fiber to the area saphenofemoral. Then, under ultrasound laser pulse starts and there is a thermal reaction: A pulse is selectively absorbed by the vessel wall and hemoglobin — is burning, which leads to adhesion of the vein wall and its further scarring. The surgeon removes the fiber gradually, burning the great saphenous vein completely. Such treatment would lead to the fact that the saphenofemoral fistula is completely blocked, the discharge of blood from the deep veins in the surface is completely eliminated. When the main problem is solved, the smaller veins can dokalyvat with sclerotherapy for the best effect.
The advantages of laser treatment of varicose veins
1) There are no incisions and, accordingly, no scars — the manipulation is performed through a small incision.
2) No complicated anesthesia — the doctor makes only a few jabs pain medication during the varicose veins.
3) There is no pain. This is how the treatment of dental caries — tooth when cured, it does not hurt anymore.
4) No Limit: literally, ten minutes after the laser treatment of a man quietly go home and lead a normal life. And not lame. Now, many can not afford to go to the hospital, do not go out to work two and a half weeks — so much requires phlebectomy. The laser technique is good because it allows you to bypass the lack of time.
5) Ideal for patients who have complications of varicose veins in the form of trophic disorders and ulcers. You do not even wait for the closure of ulcers, you can immediately carry out laser treatment — after the ulcer is closed literally 2-3 weeks instead of the usual 3-4 months.
Each method of treatment of varicose veins has its pluses and minuses, its indications and its contraindications. It is important that the doctor had all the methods and can choose the one that is best for the patient. Although varicose veins — chronic illness and eventually the symptoms may return if done in the mind, then it will happen very, very soon. And the operation is no longer required.
Source: The medical establishment on Phlebology