What are treatment options for varicose veins?
Over the past decade, we have now developed newer and much better techniques for treating varicose veins. The treatments in general depend on the degree of varicose veins, location of the varicosities, facility availability and physician experience. Unlike the past decades, the majority of varicose vein treatments are done as outpatients and include the following:
Compression stockings: For those with mild varicose veins and minimal symptoms, stockings may be the first choice therapy. Stockings do not cure varicose veins but prevent them from getting worse. The stockings must be worn on a daily basis and take time getting used to. They may be ideal for a pregnant female and for those who are bed ridden with a stroke.
Can Sclerotherapy or laser be used to treat varicose veins?
No, neither laser nor sclerotherapy is used to treat varicose veins. Both these treatments are limited to spider veins.
Vein stripping: One of the oldest procedures to treat varicose veins is stripping. Even though many individuals and other health care professionals have a negative attitude towards this procedure, it still has an important role today. The stripping is always done under general anesthesia and may require 2-3 small skin incisions. The entire vein is stripped from the groin to the ankle. Stripping still remains the gold standard for treating large "rope-like" varicose veins which run along the entire length of the leg. There is no other procedure today which can do that. After surgery, a compression bandage is worn for a few days. The pain is mild to moderate and about 5-7 days are required off work. When all the branches of the saphenous vein are carefully removed, the chances of recurrence are minimal.
Ambulatory phlebectomy: Some individuals have isolated varicose veins on the surface of the leg. Instead of stripping the vein, isolated skin incisions can be made to remove these varicosities. The procedure does require anesthesia. Small skin incisions are made over each varicosity and using special instruments, the varicosities are removed. Besides the multiple skin incisions, one also has to wear compression bandages after surgery.
EVLT: Endovenous laser treatment (EVLT) is a newer procedure used to treat varicose veins in the thigh area. The technique is done in the presence of ultrasound and a laser probe is passed through a small needle in the varicose vein. When the laser is fired, it heats up the vein and causes it to collapse and shrivel up. The procedure is relatively painless and leaves no scars. It is slightly more expensive than the other procedures used to treat varicose veins. Most individuals appear satisfied with the results. EVLT does nothing to varicose veins below the knee. Despite the massive marketing behind this technique, one should be aware that a normal or mildly diseased vein should never be removed. You never know if you may need the vein in future for your heart surgery.
Closure procedure: The closure procedure uses a radiofrequency probe instead of a laser. The procedure is very similar to EVLT in all other aspects. The radiofrequency probe generates heat which causes collapse of the vein. Again, this technique is only useful for the varicose veins in the thigh. With both the Laser and Closure procedure, potential side effects include skin burns and mild pain.
Trivex procedure: Not to be outdone by the EVLT, now we also have TriVex. This is a simple procedure which also requires anesthesia. A small incision is made in the skin and a camera is introduced. The superficial varicose veins are visualized and removed using special hooks. The procedure does require multiple skin incisions. Except for the use of a camera, the procedure is not different from ambulatory phlebectomy.
Can varicose veins be treated with herbs or minerals?
Alternative care practitioners seem to feel that everything can be treated by eating mega doses of herbs and nutrients. In truth, there is not a single herb or nutrient which can treat or prevent varicose veins. However, proper nutrition is important for the well being of the entire body.
What are preventive measures for varicose veins?
- Lose weight
- Avoid prolonged standing or sitting
- Elevate legs when at rest
- Avoid wearing tight clothes
There are numerous health care workers who are now involved in the treatment of varicose veins. Spas and Clinic around every corner offer permanent, painless and unique treatments for varicose veins. Even though these may appear attractive and luring, they usually do not live up to their claims. Before undergoing any treatment, read and learn about the procedure. Discuss the different options with your physician. Check out your physicians/surgeons credentials and ask around. If ever in doubt, get a second opinion.
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