Therefore, varicose veins should be treated at the earliest stages, when they are not yet very bothersome. This only takes an hour of your time and does not require any incisions or general anesthesia. Immediately after the operation, you can return to normal life.
3. If you remove a varicose vein, where will the blood that used to flow through it go? This is life-threatening!
Answered by phlebologist, surgeon at SM-Clinic, Ph.D. Gevorg Mnatsakanyan:
The question of where the blood from the lower extremities will go is asked by approximately 8 out of 10 patients who learn that they are indicated for surgery to eliminate varicose veins. And only a thinking person can ask this question.
Indeed, if a vein is removed or closed, where will the blood that used to flow through it go? In addition, patients also ask, “How will the leg be supplied with blood if you remove my vein?”
To answer these questions, you need to understand a little about the anatomy and physiology of the cardiovascular system.
- Firstly, the veins do not supply blood to the lower extremities . Delivery of oxygen and other vital elements to tissues is carried out through arteries – vessels through which blood flows away from the heart. Through the veins, blood flows in the opposite direction, that is, to the heart: metabolic products are removed from the tissues and transferred to the excretory organs (carbon dioxide – from the tissues to the lungs, etc.)
- Secondly, in circumstances where intervention on varicose veins of the legs is indicated, these altered veins are usually no longer involved in transporting blood back towards the heart. Why? Due to varicose veins, veins dilate and the valves that allow blood to pass only from bottom to top stop working. Thus, in a varicose vein with non-functioning valves, the blood, at a minimum, stagnates or moves in the opposite (unnatural) direction – from top to bottom. This movement of blood most often leads to complaints of a feeling of fullness in the legs, a feeling of heaviness, fatigue, swelling, burning, etc.
- Thirdly, veins have another anatomical characteristic. Unlike arteries, most of which are highways, veins are almost always a network of vessels . If you close or remove any part of this venous network, the blood will be redistributed to other normally functioning vessels. The physical and mathematical justification for the laws of blood movement through venous vessels can be found in the works of the Swiss physicist Daniel Bernoulli. By the way, it has been established that the capacity of venous vessels is approximately 18 times greater than the capacity of arterial vessels.
Thus, having examined the issues of blood movement from different angles, we come to the conclusion that in the case where there are indications for eliminating a varicose vein on the leg, this can and should be done without fear or doubt for the further functioning of the vascular system at the local level.
4. Treatment of varicose veins is a complex and traumatic operation under anesthesia. Can’t this really be avoided?
Answered by phlebologist, surgeon at SM-Clinic, Ph.D. Dmitry Blinov:
There are some strong ideas about how varicose veins are treated – some of these are outright “horror stories”. For example, that combined phlebectomy is a good, proven method in which the anastomosis of the great or small saphenous vein is ligated, and the vein is literally pushed onto it with a special probe and pulled out from the groin to the ankle.
This happens under general anesthesia, with incisions made and stitches placed. As you already understand, the operation is quite traumatic, and rehabilitation takes quite a long time. By the way, this method is already 130 years old.
And thank God, it was replaced at the beginning of the 21st century by endovenous, low-traumatic techniques.
Currently, they can officially be called the “gold standard” for the treatment of varicose veins.
These are the “three pillars” – 2 thermal techniques: endovenous laser coagulation and radiofrequency coagulation of the vein, as well as the most modern non-thermal technique – adhesive obliteration (sealing veins with bioglue), which was born in the USA.
All these techniques are done without incisions, general anesthesia and hospitalization, through small punctures, after the procedure the patient can almost immediately get up and walk. The techniques are carried out under ultrasound control, which helps to close the entire affected vein as effectively as possible.
Early rehabilitation is the key to preventing postoperative complications. Indeed, according to national recommendations, the risks of postoperative thrombosis and infectious abnormalities are 10 times lower than after open surgery, not to mention possible complications and rehabilitation after anesthesia.
And even the risks of relapse are much lower. If relapse after open surgery for 10 years is approximately 25%, then after performing endovenous techniques it is approximately 5%. And if we talk about adhesive obliteration, then, in fact, it requires almost no anesthesia, as well as wearing compression garments, which is very convenient in the summer.
When performing thermal techniques (EVLT and RFA), we recommend wearing compression stockings for 10–14 days.
Thus, we see obvious advantages of modern minimally invasive techniques compared to outdated traumatic ones. But the main thing is to understand that it is important not to start the disease and not wait for its sudden complications. A modern procedure for treating varicose veins takes on average 30–40 minutes, and you don’t have to wait 30–40 years to get it done.