Without pain and scars. How are varicose veins and other vein diseases treated today?

Swelling, heaviness, discoloration of the skin on the legs, or the appearance of visible veins are symptoms that may signal the appearance of the veins diseases of the lower extremities. Varicose veins are the most common of them.

This condition is diagnosed in 26–38% of women and 14–20% of men of working age. Often, in the early stages, people consider it to be a cosmetic problem and do not rush to seek treatment, but in advanced cases, varicose veins can lead to disability and even death.

The editors of MEDplus magazine asked Doctor of Medical Sciences, vascular surgeon and phlebologist Inna Pulyaeva how to recognize and cure such illnesses in time.

Inna Sergeyevna Puliaeva

Vascular surgeon and phlebologist

• Doctor of medical sciences

What are the most common vein diseases and do they really “get younger”?

Most often, we diagnose varicose veins of the lower extremities, thrombosis and post-phlebitic diseases (complications of thrombosis). I wouldn’t say that they started getting younger. The fact is that people began paying more attention to their health, and thus there were more opportunities to detect the issue in the early stages, even when the symptoms are not yet noticeable.

What alarm signals should you pay attention to?

Varicose veins is a hereditary disease that people are born with. Factors in its development can be a sedentary lifestyle or, on the contrary, a long stay on the feet, excess weight, diabetes, pregnancy. Clinical manifestations typically appear from the age of 18, and from the age of 30 — other stages of varicose disease. Thus, the progression of varicose veins most often occurs around the age of 30. After 40 and 50 years, most often people come with advanced cases — ulcers on the legs.

The first signs of these issues can be:

• swelling
• the presence of veins on the legs that appear dilated on the lower leg and, to a lesser extent, dilated on the thigh
• heaviness in the legs in the second part of the day. It is important to know that if people feel heaviness in the first part of the day, it is most likely a problem with the spine. But venous insufficiency manifests itself more in the second part of the day.
• discoloration of the skin on the legs, hyperpigmentation
• the presence of an ulcer is the last stage

Vein diseases have two stages: chronic and acute. For example, varicose veins is a chronic one, but it can be complicated by acute thrombosis. The latter needs urgent treatment. Also there is a difference here — acute thrombosis of superficial veins requires first conservative, and then mini-invasive treatment. Deep vein thrombosis immediately requires more complex treatment.

Chronic disease, such as varicose veins, is best treated before skin changes begin. Just like some skin changes can be irreversible.

Symptoms of venous thrombosis:

• of subcutaneous veins, the patient feels pain and the skin becomes red
• of deep veins, there’s pain in the muscles and the limb becomes significantly enlarged.

What will happen if vein diseases are not treated?

If thrombosis, especially deep one, is not treated, pulmonary embolism may occur. The latter can lead to death.

Thrombosis of subcutaneous veins can cause complications of the deep ones and, accordingly lead to the above-mentioned result.

Both types of it lead to the so-called post-thrombophlebitic disease. It cannot be treated by any conservative or surgical methods. Patients will have to wear compression stockings all the time, undergo conservative treatment, the skin will always have spots and sores, and the legs will constantly swell. Therefore, it is important to understand that all illnesses must be treated on time!

Which methods of treating vein diseases are really effective and the most gentle for patients?

For more than 10 years, patients with varicose veins have been recommended to be treated with minimally invasive methods, open surgery has for long been out of the question. Three low-traumatic treatment methods are registered in Ukraine:

• Radiofrequency ablation
• Endovenous laser coagulation

Both procedures are performed under local anesthesia, with ultrasound control, without any incisions — through a puncture of the skin. The methods are based on the use of high temperature during sealing of the vein. The result becomes noticeable within a month or two, when wearing compression stockings for up to 2 weeks.

• Bioglue.

Under ultrasound control, a catheter is inserted into the vein, through which glue is delivered to the failing ones. Glue comes into contact with the blood and quickly polymerizes, “gluing” its walls. The puncture site is covered with a plaster and the patient can go home on the same day. The procedure lasts up to 20 minutes under local anesthesia, and most importantly, you do not need to wear compression stockings after it. The effect of the procedure is felt immediately.

If the patient is diagnosed with deep thrombosis, and it is not fixed, then such a thrombus must be removed, because it can lead to pulmonary embolism. This is an urgent operation.

Patients with post-thrombophlebitic disease and valvular insufficiency, depending on the location of the lesion, undergo stenting. Usually, this is stenting of the pelvic organs.

How to preserve the health of veins for many years?

Patients who know they have varicose veins, but do not yet experience any clinical manifestations, should not delay the treatment. Modern treatment is non-traumatic and will not affect the normal rhythm of life at all. Do not wait for conditions when atrophic changes or thrombosis will begin.

If you know that your relatives have such problems, you should undergo regular professional examinations. Be careful with the use of hormonal drugs because they can lead to the risk of thrombosis.

For patients who already have varicose veins or vein disease, during any operations on other organs, I recommend to do an ultrasound of the legs, wear compression stockings and take anticoagulants as a preventive measure. This is crucial to reduce the level of thrombosis.

People who sit for a long time and are overweight are also recommended to wear compression stockings. How to choose and wear them is determined individually in consultation with a doctor.

And finally: remember: there are no drugs that would stop the development of varicose veins.

But these conditions can be detected in time and treated with minimal trauma in the early stages. So do not neglect preventive examinations. Take care!