Venous insufficiency, which is the basic mechanism in the development of varicose veins, is the leakage of blood backwards by the valves in the veins that carry dirty blood from the leg and provide unidirectional blood flow only towards the heart.
This leakage in the valves; It may develop due to reasons such as genetics, lifestyle, pregnancy and obesity. While a structural disorder develops in the valve tissue due to genetic and hormonal reasons, there is an increase in intra-abdominal pressure due to obesity and weakness of the muscles around the veins.
In addition, in people who work in a profession that requires standing for long periods of time, blood pools in the legs, veins dilate and the valves close. regurgitates blood. This leak expands the vein further and the leak increases even more. Accordingly, varicose veins, edema and skin changes develop in the future.
In addition to the appearance disorder, varicose veins also cause problems such as pain, swelling, cramps and intravascular clotting. The quality of life of people with varicose veins also decreases significantly. Intolerance develops due to blood pooling in the legs, especially when standing.
Venous insufficiency and varicose veins must be treated for our quality of life and health. However, there are rules to be followed that increase the success rate during treatment. A significant portion of varicose vein treatments performed without complying with these rules can cause more harm than good.
RULES TO BE FOLLOWED IN VARICOSCOPE TREATMENT;
1. Leaks causing varicose veins should be identified before treatment.
The leg veins of patients who apply with complaints of venous insufficiency such as varicose veins, pain and edema should be evaluated with Doppler ultrasonography before treatment. Whether the veins are blocked or not, the leaks in the valves and their degree should be determined.
This evaluation should first be performed by the physician who will perform the treatment. If any intervention is planned, a Doppler examination should be performed by a radiologist experienced in venous Doppler evaluation. Sometimes in complicated cases where Doppler ultrasound is insufficient, further examinations should be performed with tomography or MR angiography.
2. Doppler is used when deciding on treatment for children or young people. In addition to the examination, further examinations should be performed for the intra-abdominal region.
3. The treatment method to be applied should not be limited to the doctor's skills.
With the surgical treatments that have been applied to varicose veins for about a hundred years, the leaky vein section is removed. However, since many complications can occur due to this method, new less invasive techniques have been developed. The most important of these techniques are intravenous laser, radiofrequency and adhesive applications. Today, intravenous laser and adhesive applications have begun to replace surgical treatments all over the world.
4. The patient should be able to return to his normal life in a very short time.
In recent years, patients can return to their normal daily lives in a shorter time with endovenous treatments (Laser, adhesive) applied under local anesthesia. There are fewer complications after treatment and the long-term success rate is quite high.
5. After the leak is eliminated, varicose veins should be eliminated with microsurgery or foam therapy
After the procedures to eliminate the leak, which is the cause of these varicose veins, small varicose veins on the leg may disappear within 6 to 12 months due to pressure drop. However, 30% of varicose veins may remain unchanged. Therefore, following laser treatment for leakage in the valves, varicose veins should be removed with microsurgical interventions in the same session. With this technique, varicose veins are removed with 1 mm incisions and there is no scar left after the procedure. With this application, the patient should be treated for venous insufficiency and varicose veins in a very short time.
6. Very large varicose veins should be treated even if they do not cause complaints
The general cause of large varicose veins is serious valve insufficiency. As a result, blood will pool in the leg and cause clotting. In these patients, following travels, operations, or procedures that require immobilization, clots in the veins and pulmonary embolism, which is a fatal complication, may develop.
7. If varicose veins in the genital area accompany varicose veins in the legs, an investigation should be made in the abdomen for the source of the leak.
Varicose veins often occur in the legs, especially due to childbirth. In patients who urinate, varicose veins in the genital area are also accompanied. It would not be the right approach to treat these patients by only looking at the leaks in the leg veins. In these cases, advanced examinations such as MR angiography must be performed in the abdomen to detect leaks and varicose veins in the abdomen.
8. Treatment methods should be combined for an effective approach.
In a patient with superficial capillary varicose veins, if foam treatment is applied to the leak without laser, the varicose veins will recur in a short time. In other words, the patient's leakage will first be eliminated, large varicose veins will be removed with microsurgery in the same session, and approximately 1.5-2 months later, foam treatment will be applied to small or capillary varicose veins.
9. Patients with varicose veins accompanied by venous ulcers should wear compression socks after the leaks are eliminated until the wounds disappear completely.
10. In order to reduce recurrences after treatment, lifestyle adjustments must be made for new venous insufficiency. The most important of these are sports and nutrition habits.
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