With this examination, old or new clots that may exist in deep and superficial veins, obstruction, stenosis, insufficiency in venous valves, backflow rate of blood, pressure and vessel diameters can be measured. The relevant specialist physician tries to make the best decision for the patient in the light of this information. Sclerotherapy (needle treatment), foam sclerotherapy, skin laser, radiofrequency and thermocoagulation methods can sometimes be applied one by one, sometimes both together, to patients with capillary varicose veins (telangiectasia) whose deep and superficial veins are normal and there is no leakage from the intra-vein valves. It is appropriate for patients with reticular varicose veins, slightly raised from the skin and 24 millimeters in diameter, that appear bluish or greenish, to be treated with sclerotherapy or foam sclerotherapy if their vascular ultrasounds are normal. In sclerotherapy, a chemical agent, usually containing polidocanol, is injected into the varicose vein with very fine-tipped insulin needles or butterfly sets in different concentrations depending on the diameter of the vein, and the vein visibly scleroses and disappears. If we mix this liquid chemical agent with air and foam it, the process is called foam sclerotherapy. In addition to regular use of compression stockings for patients at this stage; They may be advised to avoid heat, hot baths in the Turkish bath, sand baths in the sea and excessive sunbathing, not to wear tight clothing or high-heeled shoes, to take frequent breaks on long journeys, and if they cannot, to constantly move their ankles. Some venotonic drugs may also be recommended for those who have complaints despite following these recommendations. When these patients are kept under control and there is an increase in pathologies that can be measured by vascular ultrasound at regular intervals (such as 6 months and 1 year), other treatments may be considered.
In the laser procedure, there is an area at the tip of the catheter that emits laser energy, in the radiofrequency procedure, there is a radio at the tip of the catheter. It is a region that emits waves and the catheters are connected to the main devices. Since the Laser or RF energy given into the vein with these devices will produce high heat, tumescent anesthesia is applied around the catheterized vein with 200-300 cc of cold medicated serum, and the heat energy is slowly or automatically withdrawn from the catheter tip. After the process, it is burned, cauterized, and the inner wall is destroyed in a controlled manner. The blood flow in this vein is stopped and the vein is canceled by leaving it in place.
In the bonding method, the catheter placed in the vein is a catheter with holes inside and edges. This liquid substance, whose chemical name is Nmethyl cyanoacrylate and which has been used in various treatments in the human body for years, is compatible with the body and is a strong adhesive, in a sense, like Japanese glue, is given into the vein while the catheter is slowly withdrawn with the help of a trigger device such as a gun attached to the back of the catheter. When pressure is applied within 3 seconds, the inside of the vein sticks together and the blood circulation in it stops. Thus, with these 3 methods, this vein, which has a reverse flow and high pressure and causes varicose veins, is eliminated, and varicose veins that originate from this vein and have branched and expanded are eliminated. In cases where the vein in which the catheter will be placed is very tortuous, there are very common varicose veins, or the diameter of the saphenous vein is very large, the classical surgical method must be applied. The branches of the saphenous vein, which is located through a 2 centimeter incision made in the groin area, close to the junction with the deep vein, are tied and cut, a wire called a stripper is inserted into the saphenous vein and this wire is taken out of the vein through a small incision made in the below-knee area. The upper and lower connections are cut and tied, the wire is pulled and taken out with the vein. Marked varicose veins are also removed by pulling them out through mini incisions.
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