Treatment Options for Varicose Veins
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What are the treatment options for varicose veins?
Fortunately, treatment usually doesn't mean a hospital stay or a long, uncomfortable recovery. Thanks to less invasive procedures, varicose veins can generally be treated on an outpatient basis.
Your doctor will usually try methods that don’t involve surgery first to relieve your symptoms. These may include preventive techniques like self care or the use of compression stockings. If your varicose veins do not improve with this conservative treatment, more active or interventional options may be required.
Self-care: Self-care — such as exercising, losing weight, not wearing tight clothes, elevating your legs, and avoiding long periods of standing or sitting — can ease pain and prevent varicose veins from getting worse.
Compression stockings: Wearing compression stockings all day is often the first approach to try before moving on to other treatments. They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently.
Compression Therapy for venous ulcer treatment: Four layer compression bandaging system helps manage ulcers due to varicose veins effectively. It maintains the right compression level for a week post application. You get ample amount of absorption to control exudates till one week without need to replace it. Compression stockings help reduce the pain and appearance that occurs due to varicose veins. Basically, they are used to improve blood circulation. The latest compression are designed to offer continuous pressure in your legs allowing proper blood circulation towards the heart.
Additional treatments for more-severe varicose veins: If you don't respond to self-care or compression stockings, or if your condition is more severe, your doctor may suggest one of these varicose vein treatments:
Sclerotherapy:
In this procedure, your doctor injects small- and medium-sized varicose veins with a solution that scars and closes those veins. In a few weeks, treated varicose veins should fade.
Foam sclerotherapy of large veins: Injection of a large vein with a foam solution is also a possible treatment to close a vein and seal it.In this method, Injection STD (Sodium Tetradecyl Sulfate) or Injection Polidocanol is injected into the abnormal veins in form of a Foam under ultrasound guidance by best varicose veins surgeon in Mumbai. Foam sclerotherapy is a technique wherein small amount of solution is made into foam through fast mixing and whipping along with some amount of air or CO2. This foam can then be used to treat localized lesions and varicosities and is very successful intervention technique. The procedure involves different sessions based on the count of varicose veins one has and one may require 2-3 sessions or more accordingly. You need to use bandage, compression pads and stocking for 5 days post treatment. Then remove it and wear new stocking for another 7 days. It is done on an outpatient basis and patients get very good result.
MOCA: Mechanico Chemical Ablation (FLEBOGRIF) is the latest non-thermal and non tumescent endovenous treatment for enlarged veins or varicose veins. MOCA is amongst the best treatment for patients who are not able to bear the pain of needles and also don’t have very large veins or a number of branching varicosities showing off from the treated vein. The advantage is that we don’t have to use even local anesthesia for this procedure and it is less painful than laser or radiofrequency ablation. It is a good technique and causes no thermal injury to the adjacent tissues.Though short term results are equal to laser or RF, long term results of this procedure are still not available.
Cyanoacrylate Glue embolization (Glue Ablation/ Glue closure of varicose veins):
This technique treats varicose veins effectively and is a modern non thermal technique that doesn’t involve use of tumescent anaesthesia.The glue ablation procedure is about puncturing and blocking the veins using Cyanoacrylate glue under ultrasound observation.The technique is less painful and it takes as less as 15 minutes for one leg to get treated . It allows the patients to go home within an hour. It has similar advantages as MOCA with good 3 years followup results.
Endovenous Laser Ablation:
Endovenous Laser Ablation is a most widely used minimal invasive treatment for varicose veins. The treatment involves puncture of affected vein under ultrasound guidance and Diode laser energy is used to burn and then close varicose veins.We combine this technique with foam sclerotherapy (described later) to ablate the small veins in the same sitting or few days later after the laser surgery. It is a safe and painless technique.It can be performed under local anaesthesia and is virtually scarless procedure.As it causes minimal damage to the tissues it is especially treatment of choice in patients who are on blood thinners, obese, groin infection or old age. The patient can return home on the same day as compare to conventional open surgery where patients had to stay in the hospital for some days after procedure.Overall the treatment is cheaper as compare to the conventional open surgery for varicose veins.
Endovenous radiofrequency ablation:
Radio Frequency Ablation is a minimal invasive treatment for varicose veins.In this technique, doctor inserts a thin tube (catheter) into an enlarged vein and heats the tip of the catheter using either radiofrequency energy. As the catheter is pulled out, the heat destroys the vein by causing it to collapse and seal shut. This procedure is the preferred treatment for larger varicose veins.The results are amazing and you get immediate relief from pain. You can resume your daily activities immediately with little or absolutely no pain.
Steam ablation: Steam ablation of varicose veins is the latest technique adopted by India’s best varicose vein treatment centre and it is quite simple and effective technique. The technique utilizes 1.2mm flexible catheter which is integrated via puncturing needle without the need for a guide wire or sheath. It makes the entire process safe and simple than many other methods. The patients are advised to wear elastic compression stockings post procedure for a week to move around immediately.
High ligation and vein stripping: This procedure involves tying off a vein before it joins a deep vein and removing the vein through small incisions. This is an outpatient procedure for most people. Removing the vein won't keep blood from circulating in your leg because veins deeper in the leg take care of the larger volumes of blood.
Ambulatory phlebectomy: Your doctor removes smaller varicose veins through a series of tiny skin punctures. Only the parts of your leg that are being pricked are numbed in this outpatient procedure. Scarring is generally minimal.
Endoscopic vein surgery: You might need this operation only in an advanced case involving leg ulcers if other techniques fail. Your surgeon uses a thin video camera inserted in your leg to visualize and close varicose veins and then removes the veins through small incisions. This procedure is performed on an outpatient basis.
CLACS (Cryo Laser Cyro Sclerotherapy): is an ideal technique used to treat spider veins and main veins of your leg. The technique is an integration of various techniques like sclerotherapy, laser, augmented reality and skin cooling especially for anaesthesia. The treatment yields excellent results for treating varicose veins as compared to conventional methods. Here the laser beam is used to treat vein wall or venous capillary under supervised photothermolysis that prevents the skin from damage. The patients are advised to wear elastic compression stockings post procedure for a week to move around immediately.
Varicose veins that develop during pregnancy generally improve without medical treatment within three to 12 months after delivery.