Treatment includes conservative measures otherwise called varicose veins alternative therapies , sclerotherapy techniques, thermal methods with laser or radio waves and various operations
The decision on which course of treatment is individually best suited depends on the type of varicose vein disease, the stage of the disease, any accompanying diseases and the patient’s wishes.
Varicose Veins: Conservative measures can relieve discomfort
– Physical therapy: As accompanying measures to alleviate the discomfort recommend vein specialists in all forms of varicosity physical measures such as Kneipp therapy, cold lower leg casts or treading water. Thus, the dilated veins to move in together. A lot of walking, barefoot, walking and vein gymnastics support the muscle pump function and thus the return of blood to the heart.
In addition, there are simple, but very effective vein gymnastic exercises. Ten minutes daily to improve the performance of the veins and general well-being. For this could be linked to her busy schedule usually find on days a void.
In severe chronic venous insufficiency can – by doctor’s orders and in selected cases – further measures to implement come as manual lymphatic drainage or apparatus. This achieves a decongestion of the affected leg, especially if the compression therapy alone is not sufficiently effective.
– Concomitant treatment with agents veins: veins means there is in the form of sprays, ointments, gels for application to the skin or as capsules for oral use. You can have a slightly swelling and subjectively relieve the discomfort. Veins means can and should not replace a necessary compression therapy. Your application can be useful for a limited period when compression therapy is not possible – such as allergy inclination or extreme heat – and if subjectively a favorable effect can be achieved.
More on applied here substances include, for example horse chestnut extracts (containing the ingredient aescin), extracts (polyphenols are as pharmacologically active ingredients mentioned here) from medicinal plants such as red vine leaves, arnica (the essential oils it contains, among others, have a refreshing on tired legs) and butcher’s broom ,
– Compression therapy: There are various forms of compression bandages and -strümpfen distinction.
Consistent compression therapy represents an effective measure in all venous diseases, and is indispensable especially in severe venous thrombosis with leg swelling and in the advanced stages of the disease of any origin.
You can relieve the congestive symptoms in acute thrombosis and long term reduce the incidence and severity of chronic venous failure or post-thrombotic syndrome. With her there, bringing ulcers healed, whether caused by varicose veins or thrombosis succeed. The compression supports the work of the muscle pump and the venous valves. The most important mechanism is to improve blood flow to the heart by the veins diameter of superficial and deep veins are concentrated. This has a stasis in the leg contrary very effective.
Compression bandages usually come in both acute and chronic disease situations compression stockings apply. Compression stockings are available in different thicknesses and lengths. The doctor prescribes, the dealer fit individually. After about six months of a compression stocking has had its day as a rule, because he no longer builds up the required pressure. Following a special treatment action, such a desolation, the stockings are worn for a few hours to days and after vein surgery, laser or radio wave therapy about four weeks (see below).
In certain situations, such as diabetic peripheral neuropathy, which compression treatment has to be handled very professionally to prevent pressure damage to the skin and nerves. In exceptional cases, a compression treatment is not an option, such as advanced arteriosclerosis of the leg vessels or heart failure derailed.
Assistance in case of complications
– Phlebitis (varicophlebitis): Even at a superficial vein inflammation is compression therapy (see above) is of central importance, since it usually relieves the symptoms immediately. They can be carried out with a dressing made of elastic bandages or a compression stocking. Possibly the doctor prescribes minute anti-inflammatories, non-steroidal anti-inflammatory drug or a so-called anti-inflammatory drug.
A palpable in a cutaneous vein clots can be squeezed through a tiny incision in the vein after local anesthesia. This brings immediate relief. Then, a wound dressing is applied. To promote blood circulation, the person concerned should move enough. Cooling envelopes and associations with heparin albums are often perceived as soothing and pleasant.
If a patient is not mobile enough to move the leg enough, or is the blood clot near the mouth in the deep venous system, it requires a anticoagulant (for example, low molecular weight heparin or fondaparinux subcutaneous) as thrombosis protection. The aim of this treatment with injections under the skin is to prevent the clot grows into the shadow. Possibly the continuation of anticoagulation (anticoagulant, “blood-thinning treatment”) is displayed subcutaneously or tablets for oral use, ie orally for a specific time.
– Leg ulcer (ulcer Curis): Here, the professional treatment of compression is the most important measure ever to ease the pain in the leg and bring the ulcer healed. Typically, the patient stays in motion, but stored in the idle state on the leg.
The conservative treatment of wounds in accordance with modern principles: The wound is not dry, the dressing changes are made carefully, the dressing material is not a skin irritant. This and other measures are based on the condition of the wound. With an infection, for example it is rinsed with saline and disinfected with well-tolerated germicidal solutions. It is important that each suitable cover to keep the wound moist.
Today one often uses associations of polyurethane foam or hydrocolloid material. If necessary, it is necessary to an antibiotic that the doctor prescribed for specific seed provision in the wound swab taking. If the leg needs to be immobilized, the patient receives a temporary thrombosis protection, for example with heparin syringes. Most can be ulcers with conservative measures alone bring heals. Sometimes a surgical wound cleansing (debridement) is necessary.
Invasive (engaging) therapeutic procedures
Visually disturbing spider veins or venous sacs can not be solved with drugs. If the saphenous veins were “overrun” because the venous valves no longer work properly, so that’s ultimately treatable only by switching off or removing the diseased veins.
Which method in a particular case is the most appropriate, chooses the medical interview to the previously collected findings and in consultation with the patient’s wishes. Here the advantages and disadvantages of each treatment are weighed against each other. Also it must be determined whether an intervention must be carried out urgently (for example, at a varicophlebitis with in growth into the deep venous system) or whether the appropriate date can be selected at rest.
Sclerosed (sclerosing) measures
– Sclerotherapy: by injecting a sclerosing agent into the vein is artificially produced phlebitis, so the vein walls stick together from the inside. By the time they heal. For the treatment of small veins (spider veins, reticular veins) the doctor injects the sclerosing agent in a liquid form, in large veins (saphenous veins, lateral branches, see chapter “varicose veins: screening, diagnosis”) as a foam. Following this, a compression therapy for a few hours to a few days is done.
As a rule, several treatment sessions are necessary. Since the plant remains to varicose veins, the procedure must often be repeated after one or two years. The contraindications include a known allergy to the sclerosing agent, acute venous thrombosis, edema, infections in obliteration area and a vascular disease.
Thermal Process (endovascular, endoluminally)
Exemplary here only the two processes are described, with which there are the greatest experiences: laser therapy and radio wave therapy. Endoluminal (or endovascular) means that the varicose vein is treated via a probe inserted from the inside.
– Laser therapy: Laser energy “overcooked” (coagulate) the blood and is passed to the vein wall, which heats up and then closes. The method is suitable for the treatment of not very pronounced varicose veins of the saphenous veins with relatively rectilinear course. The procedure is performed under local or regional anesthesia usually on an outpatient basis. Through a small incision in the leg a thin laser probe (diode) is inserted under ultrasound guidance in the affected varicose veins.
Aftercare: After the procedure, the patients for four weeks to wear a compression stocking. A short course of heparin syringes helps to prevent excessive blood clotting.
Laser energy – but with an entirely different device (neodymium-YAG laser) – is also used to treat the smallest, superficial, reddish-purple spider veins on the leg use. In vasodilation in the face Dermatologists make such treatment.
– Radio wave therapy: Radio waves are also able to close a Stammvarize from within by delivering heat. About a puncture in the leg the doctor inserts a thin probe, which is heated by radio waves, an under ultrasound guidance into the varicose vein. Most of this intervention is also possible on an outpatient basis under local anesthesia. The follow-up measures similar to those of laser therapy (see above).
Laser and radio wave therapy are preferably used in a slight varicosis of saphenous veins. The immediate switching off of the treated vessel is achieved in a 90 to 95 percent of cases. The diseased vessel is not removed in this process, but remains in place. Over the course of weeks, it is decayed, that it is no longer to be seen on ultrasound.
Operative treatment (varicose vein surgery)
– Stripping / part Tripping: The complete or partial removal of varicose veins aims to maintain or regain the function of the remaining veins. The procedure is performed in a minimally invasive, that is with few and small cuts.
Main application are pathologically altered saphenous veins. The stripping operation resulted in 1907 the surgeon a Babcock. He was still taken out the entire great saphenous vein from the groin to the ankle (to the here and listed below veins name again see chapter “varicose veins: screening, diagnosis”).
Since 1981, the stage-operation is carried out by Hach (part stripping). Only the diseased vein segments are removed, get the remain healthy and are possibly for subsequent bypass surgery (bypass) of arterial vessels, for example, the coronary arteries, are available.
In principle, a flexible probe is inserted through a small incision in the groin in the enlarged vein, advanced to the “stop” and brought out there again, the varicose vein severed at both ends and pulled over the probe.
A variant of this method is the cryotherapy (Kryomethode): The Strippingmanöver effected using a cold probe to the freezes the varicose vein and can then be easily removed.
Stripping operations are carried out on an outpatient basis and usually most in partial anesthesia.
Advanced connecting veins (perforating veins) are removed through a small incision in the local area, either as the sole intervention or with stripping or an endoluminal procedures in the same session.
– Miniphlebectomy: It aims at the removal of enlarged lateral branches that are pulled through very small incisions with a “crochet hook”. The method may be used alone or in combination with the stripping operation and the endoluminal techniques (see above, section “Thermal Processes”) are carried out.
– CHIVA method: CHIVA is a French acronym that translates as “ambulatory, veins sustaining, blood flow corrective treatment of varicose veins”. In this method, the physician locates under local anesthesia pathologically altered vein segments with ultrasound and then binds them off. After some time, this form back and deserted. The procedure is not recommended for very pronounced varicose veins.
– External (extraluminal) valvuloplasty (EPP): Again, nothing is removed. Instead, the doctor narrows the mouth of the great saphenous vein (saphenous vein) in the bar from the outside by a small cuff einnäht polyester under local anesthesia. The reduced extent of the vein makes the mouth Sven flap functional again.
After correcting the enlarged vein can ‘recover’, preserving the vein therefore and for a possible later needed heart surgery (bypass, see above) are fully used. However, the method is only suitable for very mild cases, that is a little advanced saphenous vein with defective mouth flap.
Surgical risks, post-treatment, recurrent varicose veins
Risks after surgery (postoperative) such as bleeding, blood clot formation and accumulation of lymphatic fluid (lymph cysts) can be minimized by the compression therapy. This is usually done for four weeks and mostly from the outset with a compression stocking. In an extended treatment connecting veins (perforating) the area is also bandaged over at least two weeks.
Even after surgical or endoluminal treatment a patient is not protected against new varicose veins. The same wire of course can not come back, the assessment remains however, why preventive measures (see chapter “varicose veins, prevention and self-help”) continue to be useful, as well as regular check-ups at the specialist physician (vascular specialists).
There are, in fact, patients who develop in the operated area, a new varicose veins (recurrent varicose veins). Mostly the side branches. Often these are so small that they do not require treatment or only a desolation.
It can also form larger varices. Or a second vessel master in the already operated region, which was originally normal, varicose acquired over the years. This can lead to reoperation (relapse surgery). The indication shall preferably experienced specialists after careful consideration.
Herbal Treatments – Herbal Treatment for varicose veins is one of the age old yet effective treatment option. Varicose veins can be cured with organic herbal food supplement. It is actually not a new concept. This type of treatment if going on for the more than 100 years in India and other countries in Asia. The ingredients of the herbal supplement is prepared out of rare herbs from the tropical rainforest of Asia.
Now a days many herbalists / ayurvedic physicians are recommending herbal supplements like VEINISH and VASKO to permanently cure the ailment painlessly.