Treatment of veins

Each serious and reliable healthcare institution that professionally deals with treatment of veins – phlebology – has to master all available methods and procedures – meaning, it has to choose the best and most acceptable method for every patient.

Therefore, the fundamental motto of Polyclinic Lege Artis should be herein repeated: Each leg has its own story. We approach every patient in a special, individual way: after the diagnostics, we choose adequate treatment procedure, which is very often a collection of different methods.

Treatment – removing the varicose veins – is not performed due to aesthetic reasons, but because of complications which inevitably occur; some can be hazardous for one’s health. It is, therefore, important to know that serious complications can be avoided if the treatment is approached to as early as possible; in that way, irreversible changes in the vascular system of legs – damage that cannot be repaired – can be avoided.

Complications

1. Thrombophlebitis – inflammation of the superficial veins
2. Phlebothrombosis (Deep vein thrombosis, DVT)
3. Ulcus cruris

More about consequences and complications of non-treated varicose veins, read .

1. Thrombophlebitis – inflammation of the superficial veins

This complication of varicose veins occurs due to blood clotting in superficial veins, because the blood flow through varicose veins is slowed down and uneven. Main symptoms of superficial veins inflammation are:

  • sudden pain at the spot of the inflammation
  • redness
  • hard, localized swelling

Given that there is no infection, it is not necessary to take antibiotics. Laics often substitute thrombophlebitis for a much more serious ailment – Deep vein thrombosis (Phlebothrombosis, DVT) – however, doctor’s examination will eliminate such misconception.

2.Phlebothrombosis (Deep vein thrombosis, DVT)

It usually occurs as a consequence of:

  • inaction, usually post-operative or due to a disease
  • perioperative bleeding
  • immobilization after a fracture
  • as a part of malignant diseases (paraneoplastic syndrome)

Clinically, it is a very serious condition which causes creation of a ‘soft’ thrombus – a blood clot, in a deep vein. Consequently, there is a retardation, or even a complete interruption of the flow of venous blood in the leg. If the clot separated, it can float up into the lungs where it can cause pulmonary embolism.

3.Ulcus cruris

Forming of the open wounds on dry, thin, atrophic skin due to damage done to venous valves of superficial, deep or communicating (perforating) veins. Most commonly appears at the inner side of the lower leg. Open wounds appear almost regularly in non-treated and varicose veins.

Kirurgija vena - Liječenje vena - Lege Artis 002

Vein disease has a mechanical cause, and it can be, actually, treated only in an active way – by surgically removing (‘classically’), in other words, closing the vein (‘endovascular’). By doing that, difficulties are completely removed.

We differentiate classical and endovascular surgical procedure.

Classical surgical procedure – stripping – is available in hospitals that offer general or vascular surgery. It has been applied for a long time, since the end of the 19th century, and it represents an inviolable surgical method. All other methods are, actually, a modification of the basic principle that states that the vein, whose valves have weakened, should be completely removed.

Classical surgical procedure implies several days of hospital stay, postoperative pain and wearing elastic bandages for 6-8 weeks. Short-term results are always good, but long-term, there is up to 40% of relapse.

New endovascular thermoablation methods are laser and radiofrequency. A special probe enters the vein that is – permanently and completely – closed using heat. Those minimally invasive and maximally efficient methods are a part of a so-called ‘same-day surgery’. They are a much more pleasant and efficient variant of the classical surgery.

UGFS – ultrasound guided foam sclerotherapy – is also a very elegant method of vein treatment, but it has its own exact indications and limitations – it is practiced in treatment of larger capillaries, all superficial and connecting veins and vein ulcer.

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