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TREATMENTS FOR VARICOSE VEINS
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.
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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