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Varicose treatments

Varicose veins are a common condition, especially for women, and can cause a few disconcerting symptoms such as mild to moderate pain, blood clots or skin ulcers. Varicose veins can be treated by simple lifestyle changes, or in more severe cases, by a simple surgery. The goal of any treatment is simply to relieve the pain, prevent complications and to give a smoother appearance.

A pre-examination is needed before having a varicose treatment to make sure that the patient is in good health and has no obstacles before having it.

Varicose vein treatment with endovenous laser ablation

Superficial venous insufficiency and varicose veins of the lower extremity are caused by venous hypertension, which is mostly the result of incompetent valves and reflux in one or more of the saphenous veins and their primary tributaries. Treatment options in patients with saphenous vein insufficiency include elimination of these incompetent pathways using endovenous laser ablation (EVLA). The procedure is performed on a walk-in basis with local anesthetic and typically requires no sedation. The patients are fully ambulate following treatment, and the recovery time is short.

Indications

The selection of candidates for EVLA involves a directed history, physical examination, and duplex ultrasound (DUS) examination.

Symptoms of venous superficial insufficiency and varicosity can be aching, throbbing, heaviness, fatigue, restlessness, night cramps, itching, edema, spontaneous hemorrhage or phlebitis. In prolonged chronic venous hypertension skin changes are possible: pigmentation, eczema and corona phlebectatica, lipodermatosclerosis, atrophie blanche and healed or active ulceration.

Technique

The underlying goal for laser ablation is to deliver sufficient thermal energy to the wall of an incompetent vein segment to produce irreversible occlusion, fibrosis, and ultimately disappearance of the vein. This procedure is performed under ultrasound guidance and tumescent local anesthesia. The complete treatment takes about 30-60 minutes and patients can return to normal activities immediately.

Postoperative Care and Instructions

Postoperative care is designed to improve efficacy and minimize side effects and the risk of complications. The most common recommendation is for class II compression stockings (30–40 mm Hg) applied immediately after the procedure and worn for 1–2 weeks.

Patients are encouraged to stroll for at least 30 minutes after leaving the procedure room and at least 1–2 hours daily for 1–2 weeks. Hot baths, running, jumping, heavy lifting, and straining are discouraged for 2 weeks. NSAIDs may be taken on an as-needed basis for discomfort.

Patients are generally seen one or two weeks after the procedure to assess the results by clinical examination and DUS.

Contraindications

Patients who are pregnant or breastfeeding
Obstructed deep venous system inadequate to support venous return after EVLA
Liver dysfunction or allergy making it impossible to use a local anesthetic
Severe uncorrectable coagulopathy, EVLA is safe with warfarin use if the international normalized ratio (INR) is between 2 and 3
Severe hypercoagulability syndromes, where risk of treatment outweighs potential benefits despite prophylactic anticoagulants
Inability to adequately ambulate after the procedure
Thrombus or synechiae in the vein or tortuous vein making passage of an endovenous device impossible unless multiple access points are chosen

Dr Juha Pekka Salenius, Specialist in vascular surgery, has extensive expertise within the diagnosis and treatment of Varicose veins. He takes advantage of new types of diagnostic methods with minimal damage to the surface, ie. modern , easy and effective treatments for varicose veins. The patient’s health benefits and service quality are particularly important aspects for Salenius.

Dr Salenius’s field of expertise: Vascular surgery, Cardiothoracic surgery, General surgery, Venous disease / Phlebology, Varicose veins, Venous insufficiency, Venous thrombosis, Arterial disease / Angiology, Cerebrovascular disease and many other treatments during local anesthesia.

Varicose treatments