Vascular and Vein surgery
Varicose veins | Varicose veins surgery | Spider veins | Sclerotherapy treatment for Spider veins
Varicose veins are twisted, enlarged veins. They arise when the valves in the veins are damaged, allowing the blood to pool in the veins. This causes the veins to swell, leading to varicose veins. The underlying reason for this is usually an inherited weakness of the vein walls. On average this affects every second person, but fortunately medical treatment is not always required. Congestion in the larger veins can lead to serious complications such as thrombosis and can significantly increase the risk of pulmonary embolism, venous leg ulcers or irreparable skin defects. Our phlebologists and surgeons specialise in the gentle but effective treatment of varicose veins and are known for their careful work. With their motto “for healthy and beautiful legs”, their focus is on restoring health with an eye for aesthetics.
Diagnosis of varicose veins
The most important requirement for the successful treatment of varicose veins is a comprehensive diagnosis. One reasons for varicose veins returning after being treated is inadequate initial examination. The objective of the diagnosis is to find diseased veins, including those that cannot be detected visually. This has only become fully possible since the introduction of modern ultrasound devices. Venous ultrasound diagnosis is extremely demanding, requires many years of experience and is carried out by vascular specialists (phlebologists). Only an experienced, well-coordinated diagnostic and surgical team can completely fulfil the requirements for effective vascular surgery.
In most cases, the surgical removal of varicose veins is the right approach, although there has been increased discussion of closure methods (e.g., laser, radio waves, steam, sclerotherapy), which are primarily used in saphenous varicosis (vena saphena magna and parva).
Varicose veins are distended veins on the leg, which not only look unsightly but may also harbour real health problems.
SYMPTOMS
Varicose veins often result from a genetic predisposition. Lack of exercise or pregnancy may, however, aggravate the onset of varicose veins by causing distension of the veins. The valves within these swollen veins, which enable the correct flow of blood, fail to close properly; blood in the venous system then becomes subject to gravity and no longer flows as it should to the heart but back into the legs. This causes swelling, congestion and water retention, leading to cramping in the calves and the symptom of “restless legs”. In old age, varicose veins can cause tissue damage leading ultimately to leg ulcers. In a worst-case scenario, they can even cause thrombosis.
ASSESSMENT
There are various treatments for varicose veins. It is important in every case that affected individuals also address the issue of preventing varicose veins by ensuring they have a healthy lifestyle, regular exercise, a weight-controlled and balanced diet as well as suitable clothing and optimal seating positions. Various therapies can be used, depending on the extent of the varicose veins: compression, sclerotherapy, medication or surgery. Choice of the correct treatment is based on careful assessment and a physical examination by a vein specialist. Should an operation be recommended, you will be referred to one of our surgeons.
The procedure will be performed as an inpatient operation involving a stay of one or two nights at the Pyramid Clinic. After consultation with the anaesthetist, you will be administered a regional anaesthetic, usually in the form of spinal anaesthesia (peridural). You will be able to get out of bed within a few hours of the operation. In fact it is quite important that you maintain regular exercise in the post-operative period. This helps reduce any swelling caused by the operation and is generally welcomed by most patients. You will also need to wear special compression stockings for six weeks following surgery.
FOLLOW-UP CARE
Normally, the pain experienced after varicose vein surgery is described as moderate. You will be given pain relief and anti-inflammatory gel, which you can apply to any hard or bruised areas along the thigh and calves. Regular walks and lying with your legs raised helps relieve the symptoms. After about twelve days you should be more or less pain free. It is normal to experience a temporary feeling of numbness in the affected skin after this kind of surgery. This is sometimes caused by stretching of superficial nerves. Recovery of these nerves may take various lengths of time (from a few weeks to months). In extremely rare cases, it can lead to a lasting loss of sensation in localised areas. Even several weeks after the operation, long periods of sitting and standing are to be avoided. When sitting down, your legs should always be raised and you should also adopt a similar position when lying down (e.g. by raising the foot of the bed or placing a pillow under your legs). For prolonged periods in a seated position, it is also necessary to resume wearing compression stockings (e.g. in aircraft or on a long car trip).
FACTS AND FIGURES
| Length of operation: | 2 to 3 hours |
| Anaesthetic: | General or local anaesthetic |
| Length of stay at the clinic: | 2 to 3 days |
| Post-operative treatment: | Bandage for 5 to 7 days, compression stockings for several weeks |
| Ready to socialise: | After 1 week |
| Back to school or work: | After 2 to 3 weeks |
| Sport: | Resume after 4 weeks |
| Costs: | Cost coverage must be requested from your health insurance company |
Spider veins are small, visible veins or varicose veins in the epidermis of the skin, which occur mainly on the legs (calves and outer thighs). Spider veins may be web or fan shaped and do not cause pain, but can be perceived as aesthetically disturbing by individuals affected.
CAUSES
Women are particularly prone to spider veins due to weaker connective tissue, which is also the cause of cellulite. Veins are not surrounded by much muscle, so firm connective tissue supports veins to carry blood back towards the heart. As the legs are farthest away from the heart, the veins and surrounding tissues in the leg have to work very hard to transport blood against gravity, which can lead to congestion of blood in the leg veins in women as young as 20. Other risk factors include lack of exercise, smoking, being overweight and genetic predisposition. This may be worsened by failure of the venous valves, which prevent backflow and ensure that blood flows in the right direction.
DIAGNOSIS
As spider veins can indicate problems with the venous system and possible future health issues such as oedema or thrombosis, professional diagnosis is highly advisable. The investigation is usually performed using ultrasound and is completely painless.
Once spider veins are visible, they cannot be treated using preventive measures such as physical activity. Depending on the diagnosis, spider veins can be treated following any vascular surgery that may be required, or purely cosmetic treatment can be performed straight away. Spider veins are removed by sclerotherapy with Aethoxysclerol injections on an outpatient basis. The treatment is effective and almost painless, and sessions take 10–15 minutes. The injected solution causes the internal walls of the vein to close and prevent blood from pooling. Sclerotherapy usually removes spider veins permanently and does not need to be repeated in the same area.