Varicose veins treatment: what are the options?
Dr Birkan Akbulut at Atatürk Public Hospital, part of the Antalya Public Hospitals Union in Turkey, discusses the latest treatments for varicose veins.
What are varicose veins?
Varicose veins are enlongated, puckered and blue-purple superficial vessels that are easily visible on the legs. They are caused when the small valves inside the veins stop working properly and blood flows backwards, collecting in the vein and eventually causing it to swell and enlarge.
They can be classified into three categories:
Large varicose veins
Reticular varicose veins
Telangiectasia (spider veins)
In some cases, two or more of the types of varicose vein are present in combination, for example spider and reticular veins. These cases require specially individualised treatment plans.
Endovenous Laser Therapy
Endovenous Laser Therapy (EVLT) involves sealing off the feeding varicose vein using heat delivered by a thin laser probe under local anaesthetic. The affected vein is painlessly destroyed and absorbed by the body. The procedure takes just a few minutes and patients are free to walk and go back home the same day. A compression stocking is worn for 4-6 weeks after treatment.
Also known as ambulatory phlebectomy, microphlebectomy is a good alternative to the complete surgical removal of varicose veins. The procedures involves making tiny punctures or incisions through which the varicose veins are removed using a hook. As the incisions are not in general closed used stitches, the process is scar- free.
Foam treatment is a type of Sclerotherapy. A sclerosing substance, which is made into foam, is injected into the varicose vein, closing it down. The risk of this method is allergic reaction and sometimes resulting hyperpigmentation areas can caused permanent discoloration.
Simple Laser Treatment
Laser treatment can be performed on the outside of the skin to treat spider veins and tiny varicose veins-like spider veins just under the skin's surface. Usually, more than one laser session is needed, as prescribed by doctor. Redness on the skin can result immediately after treatment, followed by desquamation and the recovery process. Hyperpigmentation commonly occurs in dark and bronze- skinned people.
These days, traditional varicose vein surgery or stripping is not the treatment of choice due to low success and high recurrence rates. Endovenous Laser Therapy is the preferred method. Sometimes varicose vein surgery is a treatment of last resort because of complications with the other methods. The surgery can be performed under spinal or general anaesthesia and involves the feeding varicose vein being stripped out through two incisions, one in the inguinal area and the other on the ankle.
Dr Birkan Akbulut is a vascular surgeon at Atatürk Public Hospital in Antalya, Turkey. As part of the Antalya Public Hospitals Union, the hospital provides an extensive range of modern hospital services at fair and transparent prices regulated by the Turkish Government.