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Varicose Veins

por Dra. Ángeles Herráiz

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SCLEROTHERAPY

One of the commonest treatments for varicose veins, telangiectasias and varicules is the sclerotherapy. Before starting this treatment, an exhaustive and systematic visual technique and palpation exam is needed in order to recognize not only varicose veins but also reflux points. This exam should be done on a standing up patient as this is the best position to clearly identify dilated veins for blood pressure. Also a doppler examination should be done in order to discard the existence of thrombi or insuficient valves.

Technique

With this method varicose veins are removed by chemical means with the result of obliteration, which prevents completely the new canalization of veins. This is the most harmless method of all the active treatments for varicose veins, if the indications are well established and the technique is carried out properly.

There are different types of sclerosant agents depending on its potential. The choice will always depend on the type of varicose vein to be treated.

We normally treat one leg in each session if there are enough varicose veins. The sclerosant agent is injected into the vessel’s lumen and immediately a cotton ball and compression tape is applied to the leg. Once the whole varicose area of that extremity is finished, a tight-fitting support hose is prescribed during two days. A week after, we repeat the treatment on the other extremity and so on until the varicose veins have disappeared.

Side effects

Immediately after treatment swelling and pigmentation in the treated area can occur. Systematic compression and puncture of the new thrombus can alleviate this condition immediately.

AMBULATORY PHLEBOTOMY

It is a gentle surgical procedure that removes varicose veins with local anaesthesia.

The surgical procedure consists of four stages:

  • Marking
  • Disinfection
  • Anaesthesia with adrenalized xilocain injected along the mark previously drawn.
  • Surgical procedure: a series of incisions from 1 to 2 mm along the varicose vein. By means of these incisions the vein can be found and removed. Immediately afterwards, the area should be compressed, keeping the compression up to three weeks.

Side Effects

  • Itchy sensation and cramps can occur. Lowering pressure and using a pressure gradient stocking can make it disappear.
  • Pigmentation. It will disappear easily or otherwise could be treated with depigmentation products.

Leer también
Varices por Elena Martínez Gómez

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