Varicose veins
Treatment
Varicose veins can be treated surgically (modified stripping), endovenously (laser, radiofrequency, foam sclerotherapy, sclerotherapy) and conservatively (e.g. compression stockings) with varying degrees of success depending on the findings and method. Most methods have not been sufficiently investigated without high-quality studies (study duration, comparability) - there are no long-term results as with surgical methods. The varicose veins can be treated gently and successfully without complications and without subsequent longer restrictions with modified high ligation (crossectomy), removal of only the diseased saphenous vein (great saphenous vein, small saphenous vein) and combined sclerotherapy of the lower leg veins. With this treatment we can avoid damage to the nerves accompanying the vein (saphenous nerve) and skin nerves.
Symptoms
Patients with varicose veins particularly complain about:
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feeling of heaviness,
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Itching,
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Swelling of the legs – especially in summer and/or standing for long periods of time,
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Pull,
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leg cramps,
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Pains,
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Skin changes (stasis dermatitis),
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open leg (ulcus cruris).
These complaints occur particularly in the course of the saphenous veins (great saphenous vein, small saphenous vein). When examined, patients often report tenderness. The vein wall changes (phlebosclerosis) can be detected in color duplex. There are nerves (saphenous nerve) in the vicinity of the veins, which can be damaged by the venous changes but also by therapy (stripping, endovenous laser, radiofrequency therapy) in the lower leg area. We therefore do not carry out any therapy that is associated with this risk. The combination of modified high ligation, restriction to controlled vein removal (only diseased vein) and combined sclerotherapy avoids this nerve injury.
Causes
The causes of varicose vein formation are hereditary weak connective tissue, obesity, injuries, occupational stress (standing job), gender. The vein wall and the vein valves, which are supposed to prevent downward flow when standing (non-return valve), hardly fulfill this function anymore. This leads to venous congestion and fluid transfer from the veins into the surrounding connective tissue (edema). Venous blood stasis is the cause of phlebitis, blood clots (thrombus) and embolism. The congestion causes further damage to the vein wall and valves; The process cannot be reversed even with conservative treatment (compression stocking, medication).