Modern medicine offers a large number of methods for removing blood clots from blood vessels. The most common method is thrombectomy. Thrombectomy is an operation to remove a blood clot from a vein in the leg, from a hemorrhoid, from the vertebral and cardiac arteries, and other large arteries, as well as veins. With this operation, the blood clot that blocks the lumen of the blood vessels is removed, and normal blood flow is resumed.
A thrombus is a blood clot that partially or completely blocks a blood vessel. The occurrence of blood clots can occur in large veins and arteries, in small capillary vessels. Pathological conditions in which blood clots are diagnosed are called thrombosis. The most common location of thrombosis occurs in the deep veins of the lower extremities.
If a blood clot forms on the leg, the patient will have the following symptoms:
With advanced pathology, gangrene, muscle atrophy or necrosis can form.
If you notice any of the symptoms from the list, you should immediately consult a specialized doctor. There is a danger of formation of a floating thrombus. Its peculiarity is that one of its ends is not attached to the vascular wall. Such a blood clot can break off at any time and travel with the bloodstream to vital organs (lungs, heart, etc.). A blockage in the pulmonary, carotid, or cardiac artery can be fatal.
Indications for surgery to remove a blood clot are:
The operation to remove a clot is carried out only on strict doctor’s orders, since the procedure has a number of contraindications.
Patients who have:
Also, removing a blood clot in the leg is prohibited in the last trimester of pregnancy.
The method of removing thrombosis in the vessels is determined by the attending physician, depending on the individual factors of the course of the pathology.
Why is thrombosis dangerous?
Surgery offers two main methods for removing a blood clot: traditional (removal of part of the affected vessel) and endovascular (without excision of the vessels).
The choice of surgical intervention technique is determined by several factors:
The traditional method of removing a blood clot from a vein is to cut out the damaged section of the vessel. To do this, a small incision is made above the base of the blood clot. The clot is then removed and the incision is sutured. This method is used for severe stages of thrombosis.
The endovascular method is a gentle surgical technology, therefore it is used most often. The blood clot is eliminated without removing the area of the vessel with thrombus formation.
Before surgery, angiography (examination of the vascular bed) is performed to determine the exact location of the blood clot.
The operation to remove a blood clot from an artery or vein is performed as follows. Having identified the damaged vessel, a small incision is made near the blockage. A Fogerty catheter is inserted through this opening. This tool is built like a cylinder. When inserted into the vessel, the catheter is empty.
Under radiological guidance, the catheter is moved to the location of the thrombus. Upon arrival, the balloon is filled with 0.9% sodium chloride solution and pulled back. When exiting, the filled catheter catches the blood clot and pulls it towards the incision. The manipulation is carried out until the blood clot is completely released. The number of attempts is not limited.
When diagnosing a floating thrombus, a vena cava filter is installed to protect against its rupture. This device allows you to hold the blood clot in the required place and not cause harm to the patient.
After complete removal of the thrombus, the entry site is sutured. Elastic compression is applied to the operated leg.
Such vascular surgery can take from several minutes to several hours, it all depends on the complexity of the thrombosis.
After thrombectomy, the patient can return to normal life after 3–5 days. But even after complete removal of the blood clot, the patient must adhere to medical recommendations. The patient is prescribed conservative treatment and special care.
In the postoperative period, the patient is prescribed the following medications:
And also for the first six months after thrombectomy, the patient must adhere to general recommendations on the organization of work and rest, nutrition, etc. This helps prevent the occurrence of various complications during the recovery period.
These recommendations include:
After thrombectomy, the patient is prohibited from visiting various baths or saunas. But doctors also recommend giving up bad habits that depress the state of the vascular system.
If general medical recommendations are not followed, vein thrombosis may recur. Therefore, the patient must undergo a regularly scheduled examination by a phlebologist, and, if necessary, undergo a medicinal course of treatment for thrombosis.
Thrombectomy of the lower extremities is a fairly simple operation. People who refuse such surgical intervention are at greater risk. Since a blood clot can break away from the vascular walls at any time and enter the pulmonary or carotid artery, which will lead to a stroke or heart attack. Timely medical care is the key to a long and healthy life.
Varicose veins are one of the first places in the list of so-called diseases of civilization; it is a person’s price for the ability to walk upright. In the modern world, the prevalence of the disease is breaking all records, and the population of people suffering from varicose veins is getting younger every year. This is due, first of all, to changes in the lifestyle of young people: physical inactivity, obesity, poor nutrition, and bad habits. Treatment methods for varicose veins are constantly evolving, new medications are appearing, but today the most radical and effective way to treat this disease is surgery. Many techniques have been developed for the surgical treatment of varicose veins, including laser removal. Before making a decision about surgical intervention, you need to have a good understanding of its features.
Phlebectomy is the “gold standard” in the radical treatment of varicose veins, despite all the possible consequences. This operation to remove venous vessels in the legs is indicated for patients with varicose veins, the symptoms of which are accompanied by pronounced signs of decompensated venous insufficiency:
Also, surgery to remove the affected vein in the legs is almost always indicated for thrombophlebitis.
The reason for the appointment is the data of hardware studies, the most informative of which are Doppler ultrasound and angioscanning of the affected veins.
Phlebectomy does not belong to the category of complex surgical interventions; it is performed under spinal anesthesia and does not cause significant discomfort to the patient. Currently, many techniques have been developed for carrying out such operations; we will consider the most frequently used in surgical practice.
The indication for phlebectomy is varicose veins with signs of decompensated venous insufficiency.
The surgical technique is selected individually; most often, a combination of different methods is used to increase efficiency.
Vein removal surgery is aimed at solving the following problems:
The price of the operation depends on several factors: the level of the clinic, diagnostic methods, the complexity of the operation itself, the need and methods of rehabilitation. The cost varies from 25,000 to 120,000 rubles. Patient reviews of the operation are usually good.
Despite the simplicity and prevalence of phlebectomy, it has a number of contraindications:
Also, operations to remove veins on the legs are contraindicated for pregnant women and elderly patients.
Performing a phlebectomy requires certain preparation; for two weeks before the operation, the patient must constantly wear compression garments or elastic bandages to increase the tone of the venous vessel.
The operation itself begins with crossectomy, that is, with ligation of the large superficial vein, for which a small incision is made in the inguinal fold. Nearby ductal venous vessels are also ligated during the operation.
The next stage of the operation is called stripping and consists of directly extracting the diseased vein in various ways. To avoid bleeding during surgery, it is necessary to tighten the communicating veins as well. The operation lasts on average half an hour.
Surgery is contraindicated for pregnant women and elderly patients.
The period of recovery and rehabilitation after removal of the superficial and deep veins of the lower extremities usually passes without any complications, but the patient must follow some recommendations from doctors:
After discharge from the hospital, the patient is usually prescribed a course of venotonics and anticoagulants; recovery after surgery occurs quite quickly.
In some rather rare cases, after surgery, unpleasant consequences may appear in the form of swelling, hematomas and compactions, suppuration or necrosis, and sometimes the limb may become numb. Numbness in the leg goes away with constant wearing of compression garments. In the most severe cases, deep vein thrombosis is possible, which can occur due to the patient's refusal to wear compression garments.
A less traumatic method of removing venous vessels of the lower extremities is atraumatic stripping, which is recommended if the patient is diagnosed with insufficiency of the saphenofemoral valves. This type of operation is used for resection of one or two large superficial veins. During the operation, a small incision is made in the groin area or under the knee, and a special probe is inserted through it into a pre-ligated vein. During the operation, the veins can be removed under local anesthesia; the procedure does not require the patient to stay in the hospital, he can be discharged on the day of the operation. Reviews about this treatment method are usually good, the cost is about 15,000-20,000 rubles.
The indication for atraumatic stripping is insufficiency of the saphenofemoral valves.
The recovery period after this type of operation is short, and this is its undoubted advantage over standard phlebectomy, but compression garments must be worn for two weeks after the operation.
This type of operation was actively used for radical treatment of varicose veins of the lower extremities at the beginning of the 21st century; nowadays, with the development of intravascular surgery methods, the technique has become less used. Endoscopic dissection is used if, in addition to the vertical one, it is necessary to eliminate the horizontal discharge of blood through the perforating veins.
During the operation, an endoscope equipped with optical instruments and a channel for inserting a surgical instrument is inserted into a specially prepared incision. The expansion of the vein cavity is carried out using carbon dioxide, which helps the surgeon visualize the area of operation.
The cost of the operation depends on the level of its complexity and the need for postoperative rehabilitation, approximately 20,000 rubles.
Sclerotherapy is not a surgical operation in the usual sense, but since its technique involves the introduction of a special substance into a vein, it is associated with a certain traumatic effect on the veins. Sclerosis is indicated at the initial stage of the disease. During the procedure, a puncture is made over the area of the vein in the leg, through which a sclerosant is injected into the vein using a needle or microcatheter, which glues the damaged vein.
Sclerosis is indicated in the following cases:
Contraindications for sclerotherapy are the same as for phlebectomy, but in addition it is necessary to carry out allergy tests to sclerosant. In addition, sclerotherapy is not recommended for patients with diabetes.
After the manipulation, the following recommendations must be observed:
Prices for this procedure are specified in a specific clinic, on average about 5,000-10,000 rubles.
The most effective and popular method of radical treatment of varicose veins of the lower extremities today is laser coagulation, which has the best reviews from patients. Laser removal of leg veins occurs using a special light guide, which makes it possible to treat the vein from the inside and glue it together.
Laser coagulation has a number of limitations and contraindications; it may be ineffective in cases of damage to the deep veins of the lower extremities, as well as in advanced forms of varicose veins and in the event of the appearance of trophic ulcers and varicose dermatitis.
Removal of veins on the legs with a laser is carried out on an outpatient basis; the procedure is done without anesthesia, since the area of exposure is minimal.
The operation proceeds according to the following scheme:
After laser removal of leg veins, blood circulation goes into the deep veins of the lower extremities, located inside the muscle tissue.
Laser coagulation is the most effective method of treating varicose veins.
Laser coagulation is absolutely atraumatic, leaving no cosmetic defects on the skin. On the Internet you can watch materials (videos) on the operation.
It is better to find out the price of laser coagulation in specific clinics, because it can cost differently depending on the class of the clinic and the level of equipment. On average - 35,000-55,000 rubles.
After completion of the procedure, the patient is immediately allowed to stand up, rehabilitation proceeds in the same way as with other types of surgery, and consists of constantly wearing compression stockings for two months after surgery. The unpleasant consequences of laser exposure consist only of a slight tingling of the skin at the incision sites.
Modern surgical phlebology offers many methods of radical treatment of both superficial and deep veins of the lower extremities. The choice of method depends on individual contraindications, the general condition of the patient, the price of the operation and many other factors. Before surgery, the patient must undergo a complete examination. The most modern way to remove damaged veins is laser exposure; this method has excellent reviews from patients, but in any case, the procedure for performing the operation, as well as the possibility of using a laser in treatment, are determined by the doctor.
Varicose veins are a serious disease characterized by deformation of the venous walls and the occurrence of stagnant processes inside the blood vessels. If the disease is in an advanced stage, conservative treatment is not enough. In this case, surgery is necessary to remove the affected part of the vein. How is the operation performed? How much does the procedure cost? And what dangerous consequences await the patient if he refuses radical treatment? The characteristics of surgical interventions and their prices are in our article.
Despite the fact that the initial stages of varicose veins can be treated conservatively, 5% of all surgical operations involve the removal of a deformed section of veins. This is due to the fact that many patients are in no hurry to see a doctor, self-medicate, or completely ignore the problem of varicose veins. When a person comes to an appointment with bulging venous nodes, severe swelling of the legs or progressive inflammatory processes, the question of a radical solution to the problem is raised.
In order to understand whether it is worth undergoing surgery to remove part of a vein and which surgical technique will protect against dangerous consequences, the patient needs to undergo a number of diagnostic examinations of the lower extremities and general health. These include:
In addition, duplex scanning of the veins is necessary, which is a color dynamic ultrasound method. It is done to identify pathologies of the valves and walls of the veins in the legs.
The following body conditions are contraindications to surgery to remove part of a vein:
The answer to the question of how much the operation costs depends on the method of removing the deformed part of the vein. The average price for procedures is:
What's included in the price
Excision of a deformed vein
4-5 sessions under the control of Venovisor
Fragmentary or local impact
The cost of the operation is affected by the complexity of the equipment, the number of sessions and the size of the affected vein.
There are several modern surgical techniques that can cure a venous vessel and restore the nutrition and metabolic processes of neighboring tissues.
During this operation, a specialist excises and removes the vein affected by varicose veins from the leg. Before the start of the surgical procedure, diagnostic studies are carried out to determine the exact junction of the diseased venous canal with the central main vein, as well as the zones of greatest expansion of the nodes. These locations are marked with a surgical marker. Then pinpoint punctures are made, through which parts of the diseased venous vessel are tied, cut off and pulled out. After watching the educational video of phlebectomy, you can note that after the operation on the veins of the legs, only small scars remain at the puncture sites, which over time become almost invisible.
If the varicose process has affected a vein of small diameter, then the patient is offered a more gentle method of removing the vessel - sclerotherapy. This operation can be done under local anesthesia under the guidance of an ultrasound scanner. The doctor uses a syringe to make a thin puncture in the vein and inject a special substance, sclerotant, into the damaged vessel. This foam-forming mass glues the walls of the vein, after which the damaged part falls off and is gradually absorbed in the body, without harmful consequences for health. There is no clear answer to the question of how many injections are needed for complete recovery. Their number depends on the individual characteristics of the body and the severity of the disease.
Another gentle method of surgical treatment of varicose veins without health consequences is laser coagulation. It is based on the use of a high-energy beam, under the influence of which the desired section of the blood vessel is destroyed. In this case, the equipment allows you to direct the flow of energy so precisely that neighboring tissues remain undamaged. The advantages of this method include the ability to treat two legs at once in one operation. The disadvantages are the difficulty of purchasing expensive equipment and training of medical personnel. Reviews from patients indicate the ease of this procedure and the absence of cosmetic defects on the skin of the legs.
No matter how expensive and troublesome the operation to remove veins may seem, it cannot be postponed for a long time. After all, varicose veins can be complicated by many pathological conditions that threaten not only health, but also human life. Therefore, patients of phlebology clinics must follow all instructions and recommendations of a specialist regarding conservative treatment, surgical procedures and the postoperative period.
How long does rehabilitation take after surgery? The answer to this question depends on many factors. The more modern and gentle the surgeon used, the faster and more painless the postoperative period will be. Therefore, before starting treatment, make sure that the clinic is certified to use various treatment methods, and the surgeon has sufficient experience in this medical field.
Otherwise, the risk of developing pathological processes increases. What postoperative complications can occur after vein removal? The most dangerous consequences are the formation of blood clots, damage to a nerve or an adjacent blood vessel (for example, the sural vein). Temporary unpleasant conditions characteristic of the recovery period after any phlebological operation include:
To speed up the recovery of the body and prevent the occurrence of dangerous consequences, it is necessary to adhere to certain rules. The first step is to wear compression stockings after surgery. They will prevent the dilation of blood vessels, accelerate blood flow, and prevent the development of stagnant processes in the legs in the postoperative period. Reviews from patients indicate their high effectiveness, which is why many people continue to wear compression stockings even after recovery.
In addition, you should continue to take medications to thin the blood and strengthen the walls of the veins to prevent the consequences that arise from bed rest. In the second part of the rehabilitation period, you should maintain reasonable physical activity: stand while holding the handrail, and then walk and do simple leg exercises.
Surgery to remove deformed veins in the legs is a necessary part of the treatment of severe varicose veins. To prevent dangerous consequences associated with weakening of the body in the postoperative period, it is necessary to wear compression stockings, take medications and perform simple leg movements. The doctor decides how long these requirements should be adhered to, based on the characteristics of the circulatory system and the severity of the operation.
Currently, removing a blood clot from a blood vessel is possible using various modern methods, the most common of which is thrombectomy. It is necessary to consider in detail what this surgical intervention is, the main stages of its implementation, and indications for its implementation.
Thrombectomy is an operation to remove a blood clot blocking the lumen of a blood vessel in order to restore normal blood flow.
A thrombus is a blood clot that partially or completely blocks a blood vessel. It can be attached to the vessel wall in a parietal, floating or occlusive manner.
The most dangerous is a floating thrombus, when one end of it is washed with blood on all sides. There is a real danger of it being torn off from the wall of the vessel and entering the heart, lungs or other important organ along with the bloodstream, which will lead to serious complications or death.
A disease in which blood clots are diagnosed in blood vessels is called thrombosis. Blood clots can form in large veins and arteries, and in small capillary vessels. But the deep veins of the lower extremities are most prone to thrombosis. With thrombosis of the veins of the legs, swelling, discoloration of the skin, and excruciating pain appear at the site where the blood flow is disrupted. In particularly severe cases, muscle atrophy, necrosis and gangrene may occur in the leg.
Indications for thrombectomy of the veins of the lower extremities should be considered:
Surgical intervention is contraindicated in patients:
Only the doctor makes the decision to perform emergency or planned surgery on an individual basis for each patient.
The advantages of thrombectomy of the lower extremities are:
If surgical intervention is unsuccessful, various complications are possible in the form of recurrent thrombosis, wound infection, etc.
It should be noted that removing blood clots from a blood vessel is a necessary emergency measure to improve the patient’s condition, but does not eliminate the disease itself - thrombosis, which requires mandatory treatment.
Before deciding on surgical intervention, the phlebologist will clarify the correct diagnosis. During diagnostic procedures, the exact location of the blood clot, the method of its attachment to the wall of the blood vessel, and the degree of damage caused to tissues as a result of disruption of normal blood flow are established.
The following examination methods are used in diagnosis:
After making a diagnosis, the doctor sets a day for thrombectomy and gives important preoperative recommendations.
It is worth noting that surgical treatment of veins in the leg is carried out under local anesthesia, so no special preparatory measures are taken. During this period, the patient is recommended:
Colon cleansing using an enema is not required in this case.
Thrombectomy requires modern equipment and specially trained doctors. The surgical technique is not particularly difficult and allows you to get blood clots in almost any arteries and veins. There are 2 ways to perform thrombectomy:
With the traditional technique of performing this operation, a vein is found and incised above the affected area. A special instrument is used to remove a blood clot that is blocking blood flow. The incision is then sutured.
Endovascular thrombectomy removes the clot with a balloon-tipped catheter while maintaining the integrity of the blocked blood vessel except for a small incision to enter the vein.
Surgeons use a catheter to find a blood clot, capture it and remove it. During the operation, the manipulation of the balloon catheter is monitored using x-rays.
The procedure for clearing blood clots from a vein can be performed multiple times. Then the site where the equipment enters the vein is sutured. An elastic bandage is applied to the operated leg.
If a floating thrombus is diagnosed, a vena cava filter can be installed for additional insurance. In the event of a sudden detachment of a blood clot, this device will be able to keep it in the right place and prevent serious complications. After the operation, control arteriography is performed.
This type of surgical intervention is performed in the vascular surgery department and, depending on the complexity, can last from several minutes to 2 hours.
After thrombectomy of the veins of the lower extremities, successfully performed by qualified specialists, the patient will be able to return to everyday life in a few days.
In the postoperative period, conservative treatment is carried out as prescribed by the attending physician:
To avoid various complications, it is necessary to follow some recommendations in the first 6 months after surgery:
In some cases, despite following all the specialist’s recommendations, thrombosis of the veins of the lower extremities may recur. In this regard, you should regularly undergo examination by a phlebologist and, if necessary, undergo a course of treatment.
Thus, if thrombectomy is performed in a timely manner and all prescriptions of the attending physician are followed, the patient will be able to return to normal life within a short time.
If conservative treatment does not produce positive results, the patient is prescribed phlebectomy - an operation to remove varicose veins. This type of intervention is recommended for:
In many cases, surgery is necessary. This procedure is prescribed in advanced forms and in the absence of effect from conservative treatment.
If you have allergies or take medications or dietary supplements, tell your doctor about this during your preliminary consultation. Also, before the operation, it is mandatory to take tests and undergo a vein examination using color Doppler mapping.
A few days before event “X”, go on a light diet. Eliminate fried, spicy, salty, spicy, and starchy meats from your diet. Drinking alcohol and smoking are contraindicated.
For successful treatment of varicose veins by surgery on the leg there should be no injuries, ulcers, hematomas, or trophic ulcers. If there are any, the doctor will prescribe special therapy to eliminate the defects.
Remove the nail polish and shave your leg with a razor. You cannot use hot wax or depilatory, as their particles can become a source of infection.
Important: if general anesthesia is indicated, do a cleansing enema. On the day of the procedure, wear comfortable shoes and loose clothing.
The subcutaneous vessels are removed, redirecting the blood through the deep veins. In this case, the load on them will increase by a maximum of 10%, which is not critical. Surgery to remove varicose veins on the legs is performed using local, general or epidural anesthesia.
Typically, the procedure consists of the following parts:
On average, surgery lasts 1-3 hours. If the operation is performed on time, then there is no need to remove a large vein. You can limit yourself to miniphlebectomy and ligation of connecting vessels. As a result, the risk of complications will decrease, and postoperative rehabilitation will be easier.
2 hours after the operation - for varicose veins of the lower extremities - it is recommended to begin making micromovements with the leg: turning, bending it. It is worth raising the edge of the bed by 9 cm, so it will be much easier for the veins to adapt to the increased load.
The next day, both legs are bandaged with an elastic bandage from the toes to the thigh. You are allowed to stand up only after the dressing has been properly performed. At home, bandages can be replaced with compression stockings. The degree of compression and size will be determined by a phlebologist.
If there are no complications, the patient is discharged 24-48 hours after surgery. Next time you need to come to the hospital to remove the stitches in 8 days. By this time, the incisions should have healed.
In each individual case, recommendations for varicose veins after surgery will vary. They depend on the stage of development of the disease, the amount of work done by the surgeon, the age and general health of the patient.
Medications are prescribed to relieve pain and prevent blood clots. A light massage directed from the foot to the thigh is also useful. It is not recommended to put increased stress on the vessels of the legs for a week and a half. Put off going to the sauna, gymnastics, aerobics, and exercise equipment. You can wet your leg only after removing the stitches.
For the first three days, the compression garments are not removed. Afterwards, be sure to wear it during the day for at least 2 months.
With varicose veins, the postoperative period is quite long. Moderate physical activity will be useful to restore venous circulation. Slow walks, swimming, warming up your feet, water aerobics, and yoga are good. In six months, if the doctor allows it, you can ride a bike.
Of course, any operation is not only getting rid of a disease, but also a difficult test for the body. You may be lucky and get through it with ease. But you should also mentally prepare for possible complications:
To minimize the consequences of a complex operation, you should strictly follow your doctor's recommendations. This way you can avoid inflammation and quickly return to normal life.
Unfortunately, the operation only removes the damaged veins, but not the causes of the disease. To prevent further progression of varicose veins, you need to reconsider your lifestyle.
It is important to analyze the situation and find out what triggered the development of the disease. Then - eliminate the cause. If this is impossible (for example, a genetic factor), it is worth compensating for the risk as much as possible with preventive measures.
To prevent varicose veins from returning after surgery, you must wear compression garments. If you have to stand for a long time, trample from foot to foot. When working sedentarily, perform passive exercises for the feet.
Do contrasting douches in the morning and evening. Even if the disease does not bother you again, undergo an annual preventive examination with a phlebologist.
Surgery to remove veins in the legs may be necessary if surgical treatment of varicose veins is necessary. The need for surgical intervention is the responsibility of a phlebologist; only he, based on the results of the examination, can determine which type of operation is suitable in each specific case. The operation is performed only in a hospital setting, subject to all rules of asepsis and antiseptics. The postoperative period depends on the type of operation, the extent of the pathological process and the general condition of the patient.
Before deciding to undergo surgery, it is better to familiarize yourself in more detail with some of the features of its implementation. When choosing a clinic for an operation to remove diseased veins, you need to focus on the level of qualifications of the specialists and the reviews of patients who have already undergone treatment there.
So, you need to remember that:
The doctor will first prescribe the necessary diagnostic measures and only then, based on their results, select treatment.
Any method of surgical intervention involves the appointment of a set of postoperative rehabilitation measures to consolidate the effect. You need to wear compression stockings and do special exercises. If such measures are not followed, serious complications may develop.
There are seven options for performing surgery on the veins of the legs. Each of them has its own indications, so the doctor selects a specific type of operation based on the characteristics of the pathology and the capabilities of the clinic where the operation will be performed.
Classic surgery to remove diseased veins in the legs requires hospitalization, general anesthesia and a long period of rehabilitation. This measure is prescribed in severe cases of varicose veins, when alternative surgical options are impossible.
Modern surgery to remove a diseased vein in the legs is a minimally invasive procedure. There are several options for operations of this kind; they do not require a long stay in a hospital setting and are characterized by a short rehabilitation period. The main advantages of minimally invasive interventions include:
It is necessary to consider in more detail all methods of minimally invasive operations on the veins of the lower extremities in order to understand in what cases and how the affected vessels are removed.
This method involves excision of the entire vein, but in a minimally invasive way, through several punctures. The duration of this intervention is 40 minutes. Miniphlebectomy is indicated in the following cases:
This vein removal technique is suitable in situations where treatment of superficial varicose veins is required. This removal of leg veins has shown to be effective for reticular varicose veins. This operation takes place by injecting a foam or liquid sclerosing composition into a vein.
Sclerotherapy can only be used to treat superficial varicose veins.
Laser coagulation is the most common minimally invasive technique. Removing veins on the legs with a laser allows you to effectively and painlessly remove the affected areas of the blood vessels. The price at which laser coagulation is performed is the lowest among all minimally invasive methods. Laser removal of even deep veins of the lower extremities does not require much time both for the operation itself and for the rehabilitation period.
This technique allows you to eliminate the consequences of varicose veins of the deep veins of the lower extremities. This operation is carried out similarly to a laser one, but involves the effect of radio frequencies on the affected areas of the blood vessels. It has fewer side effects; after this intervention there are no scars left. Radiofrequency surgery is also performed in situations where the use of laser treatment is contraindicated. The cost of such an operation to remove leg veins is slightly higher than endovenous laser coagulation.
The steam micropulse method involves gluing highly tortuous vessels. The advantage of this method is its short duration and rapid rehabilitation. No marks are left on the skin.
This technique is the most modern and highly effective. It allows you to glue the affected veins on the leg using a special biological glue. After such an intervention there is no need for rehabilitation measures, even in the form of compression. This operation will cost quite a lot, but the reviews from both doctors and patients about it are very positive. It is worth noting that this procedure is absolutely painless; there is no need even for local anesthesia. Gluing of veins does not provoke a violation of skin sensitivity and the appearance of hemorrhages.
After the procedure, no rehabilitation measures are required.
The choice of a specific operation option should be made by a phlebologist according to the patient’s health condition. To learn more about all the techniques, you should watch a video about the main methods of surgical interventions.
Recovery after surgery depends on the method of intervention and the severity of the pathology. After vein removal using the Varadi technique, laser coagulation, or sclerotherapy, traces of injections may remain on the skin. After the listed interventions on the area of the superficial and deep veins of the lower extremities, it is necessary to wear compression stockings to prevent the formation of blood clots. Your doctor will help you choose knitwear.
After the gluing technique, the consequences are less severe, and there is no need for compression rehabilitation measures. But in any case, even after such an operation, physical activity on the leg area is limited.
After surgery, the doctor also prescribes a set of exercises that have a good effect on the area of the deep veins of the lower extremities, significantly improving their condition.
Compliance with all rehabilitation measures will prevent such consequences as the formation of blood clots, numbness of the limbs, and pain. Therefore, it is important to undergo a rehabilitation course prescribed by a specialist so that the operated area does not become numb, painful, and to reduce the likelihood of blood clots forming. Also, preventive measures help normalize venous blood flow in the lower extremities.
The price of surgery depends on how the affected vessels will be removed. It is worth considering the prices for the two most common operations - laser coagulation and radiofrequency ablation.
The cost of laser coagulation in Moscow is about 653 euros for severe stages of varicose veins. In St. Petersburg, a similar intervention costs 512 euros. In Belarus, such an operation costs 502 euros, in Ukraine – 450, in Latvia – 495. The price of laser vein removal in Germany and Israel is several times higher. The cost of radiofrequency ablation in Moscow is 700 euros. In Belarus and Ukraine, the price of such an operation is 500 euros, in Latvia – from 600 euros. A similar intervention in Germany and Israel costs about 6 thousand euros.
Phlebectomy is a surgical procedure to remove varicose veins. The purpose of phlebectomy for varicose veins is to normalize blood flow through the deep veins. Therefore, if surgery for varicose veins is indicated, you should not hesitate to carry it out, because the sooner it is performed, the faster the normalization of blood flow, improvement or cure of other disorders and complications of varicose veins will occur.
Preparing for vein removal surgery is absolutely simple
Take a shower, completely shave the leg on which the operation will be performed; before the operation, the skin of the legs should be healthy and free of any pustular diseases. If the operation is planned to be performed under general anesthesia, mandatory cleansing enemas are prescribed on the eve of the operation. Please come to your surgery in loose shoes and clothing. If you are taking any medications, be sure to tell your doctor.
Various medications may be used during surgery, and if you are intolerant or allergic to any medications, especially novocaine and iodine-containing substances, be sure to inform your surgeon.
In the surgical treatment of varicose veins, the diseased veins are simply removed. This operation takes about 1-2 hours. Removal of the saphenous veins does not interfere with normal blood flow and is safe for the body, because no more than 10% of the blood normally flows through the saphenous veins (which are what varicose veins affect). 90% of venous blood is carried by the deep and so-called connecting veins of the legs. Therefore, when veins under the skin are removed, these vessels easily take on the burden of blood circulation. After the operation, almost invisible scars remain, only 4-5 mm.
If improperly functioning vein valves are identified, extravasal correction of the incompetent valves is performed in order to restore normal blood flow. After vein surgery, you need to follow some recommendations, the main one being elastic compression.
After surgery, the patient is recommended to use an elastic bandage or elastic stockings around the clock for 1.5-2 months. Additionally, venotonic drugs are prescribed to restore the function of the operated legs.
However, such operations are still accompanied by a high risk of scarring. Recently, methods have been developed that make it possible to perform plastic surgery on the valves of the great saphenous vein without excision of the veins. These operations for varicose veins are very effective, but are still very complex and are performed by a small circle of specialists.
After vein removal surgery, recommendations will vary for each patient - it all depends on the degree of varicose veins in the patient, the presence of chronic diseases, general health, as well as the nature and extent of the operation. Therefore, after vein surgery, listen carefully to your surgeon and follow his recommendations.
From the first hours after surgery, it is recommended to turn around, bend your legs, etc. And simply raising the end of the bed by 8-10 cm significantly improves venous blood flow.
The day after surgery for varicose veins, a bandage is performed using compression hosiery or an elastic bandage on both legs from the toes to the knee joints. It is allowed to walk only after bandaging. Also, after vein removal, physical therapy and light massage are recommended to prevent blood clots.
For 7-10 days after surgery, you should not engage in aerobics, gymnastics or exercise bikes, or visit the sauna or bathhouse. On days 8-9, the sutures are removed and a course of physical therapy and water procedures is prescribed. Elastic compression is necessary for at least 2 months after the stitches are removed.
Exercises for varicose veins are especially important for older people. This is an ideal prevention of postoperative complications - slowing down the venous outflow of blood and postoperative thrombosis. It is possible that medications will also be prescribed to prevent blood clots.
Complications of phlebectomy are unlikely, but they do exist. The nature of complications depends on the severity of damage to the venous system and, of course, on other concomitant diseases. On the first day, bleeding from wounds and bruises are possible. Light bleeding is due to small subcutaneous vessels that were not tied off during surgery, and bruises disappear within 7-10 days after surgery.
Thromboembolism (blockage of the arteries as a result of the separation of part of the blood clot) after removal of varicose veins can be caused by deep vein thrombosis of the lower extremity. Deep vein thrombosis is a rare complication of phlebectomy, the causes of which are slower blood flow through the veins, infection in the wound, and prolonged bed rest. Prevention of a blood clot is getting up at the first beat after surgery, compression therapy and the use of medications that improve the properties of the blood.
Surgery for varicose veins also does not exclude the development of relapse - only diseased veins and varicose nodes are removed. But over time, if the varicose vein prevention regimen is not followed, even healthy veins can become diseased. Treatment started at the earliest stages is the most effective.
The cosmetic effect after phlebectomy largely depends on the stage of varicose veins, the characteristics of the venous system itself and the presence or absence of complications of varicose veins. Thus, in the initial stages of varicose veins, the size and number of scars can be minimized. If varicose veins are advanced and accompanied by trophic ulcers, dermatitis and extensive pigmentation, these cosmetic defects remain even after surgery, along with small scars at the incision sites. The cosmetic effect of phlebectomy seriously depends on the individual predisposition to the formation of scar tissue. In some, even with serious damage to the skin, thin scars form. Others, even with very minor damage, are predisposed to the formation of a rough keloid scar protruding above the surface of the skin.
In recent years, in phlebology centers specializing in the treatment of varicose veins, the method of miniphlebectomy (microphlebectomy) has become increasingly widespread. Miniphlebectomy is the removal of veins through tiny punctures in the skin. This procedure does not require large incisions like varicose vein surgery. Depending on the stage of varicose veins, microphlebectomy may not require either hospitalization or general anesthesia. The miniphlebectomy procedure can be performed on an outpatient basis, with a minimum of local anesthesia, because miniphlebectomy is an absolutely painless technique.
After removal of varicose veins, bruises form in the area where they were removed. The bruises go away on their own within 2-3 weeks, and after 1-2 months there are practically no traces of varicose veins or surgery left.