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Treatments for Varicose
Veins
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Typically, the first line of therapy for
varicose veins is compression therapy. The patient wears support stockings
and elevates his/her legs as often as possible throughout the day. The
support stockings and leg elevation reduce the pooling or backward flow of
blood.
Another option for treatment of varicose
veins is sclerotherapy. A special liquid is injected into the affected vein.
The liquid contains an irritant that causes inflammation and fibrosing of
the vein -- closing off the affected area of the vein. This forces the
rerouting of blood through more healthy veins.
A more invasive treatment for varicose veins is surgery. In traditional vein
stripping, the surgeon makes a long incision in the leg. A special wire is
inserted into the incision and down through the vein. The wire is then used
to pull the affected vein out through the incision. The procedure leaves a
long empty channel in which blood can accumulate. The surgery causes a lot
of trauma to the limb and a lot of post-operative pain and discomfort.
Patients generally require a two-day stay in the hospital for recovery.
Some doctors are using a less invasive surgical technique for the treatment
of varicose veins. The surgery is known as an ambulatory phlebectomy.
Several tiny puncture incisions (four or five, about two inches apart) are
made along the skin over the affected vein. A special small hook is placed
through the incision and under the vein. As the surgeon lifts the hook, the
vein is gently pulled out through the incision.
The vein is then clamped and that section of the vessel is removed. The
procedure is repeated through each incision until the desired length of vein
is removed. Since the procedure is less invasive and less traumatic, the
patient only requires a local anesthetic. The surgery can even be done in
the doctor's office or in an outpatient hospital setting. The tiny puncture
wounds heal very quickly and usually leave no scars. As with traditional
surgery, there is still a small risk of nerve injury with the ambulatory
phlebectomy.
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BIBLIOGRAPHY
Bohler, Kornelia, et al., "Varicose Vein Stripping -- A Prospective Study of the
Thrombotic Risk and the
Diagnostic Significance of Preoperative Color Coded Duplex Sonography,"
Thrombosis and
Haemostasis, April 1995, Vol. 73, No. 4, pp. 597-600.
Goren, Gabriel, M.D., and Albert Yellin, "Ambulatory Stab Evelsion Phlebectomy
for Truncal Varicose
Veins," The American Journal of Surgery, August 1991, Vol. 162, No. 2, pp.
166-174.
Goren, Gabriel, M.D., and Albert Yellin, "Minimally Invasive Surgery for Primary
Varicose Veins,"
Annals of Vascular Surgery, July 1995, Vol. 9, No. 4, pp. 401-414.
Guex, J.J., "Thrombotic Complications of Varicose Veins," Dermatologic Surgery,
April 1996, Vol. 22,
No. 4, pp. 378-382.
SOURCE: Copyright WTVC NewsChannel 9 Chattanooga, TN
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