VARICOSE VEIN TREATMENT
Varicose vein treatment is determined based on the type of varicose veins and the degree of leakage according to Doppler ultrasound results.
Sclerotherapy
Sclerotherapy is one of the treatment options that can be applied to patients with reticular veins or telangiectasia (spider angioma) less than 4mm, or in cases where there is no deep or superficial venous insufficiency documented, or in patients who have been treated for superficial venous insufficiency. In this method, injections are made into the prominent vein with fine needles. The goal is to create a reaction within the vein by injecting alcohol-based medications into these vessels. Subsequently, by creating compression with elastic bandages, these veins stick together, preventing further blood flow, and eventually disappear. This method yields better results when applied in cooler weather, as these veins tend to expand in hot weather. The smaller the diameter of the vein, the more successful the response to treatment.
Exolaser
Exolaser is another treatment option that can be applied to patients with reticular veins or telangiectasia (spider angioma) less than 4mm, or in cases where there is no documented deep or superficial venous insufficiency, or in patients who have been treated for superficial venous insufficiency. In this method, laser beams are applied to reticular or telangiectatic veins from outside the skin to burn and eliminate the vein. If topical anesthetic creams are applied about half an hour before the procedure, it becomes less painful.
Traditional (Conventional) Stripping Operation
Traditional stripping is the classic treatment method applied in cases where there is a 3rd or 4th-degree leakage at the valve where deep and superficial veins intersect (safenofemoral junction) according to Doppler results, and when the normal vein diameter has increased two-fold or more. In this procedure, performed under general or spinal anesthesia, the dilated main vein is removed through two incisions, one at the ankle and the other at the groin. A steel cable is passed through the vein, and after being attached to the vein at the lower end, the vein is pulled out using this cable after being released from both the upper and lower sides. Other veins remaining outside the normal vein line are marked before the operation, and after this procedure, they are also removed with one cm incisions (avulsion phlebectomy). This method is less commonly applied nowadays due to the development of newer sealing or endovenous laser applications. Newer methods are technically easier and the recovery period for the patient is shorter. In the traditional method, since the ends of the veins attached to the removed vein are left exposed, it is a somewhat bloody operation, and as a result, the patient may have difficulty walking in the first 10 days after surgery, and complete recovery takes about a month.
Endovenous Laser Stripping
Endovenous laser stripping is a modern treatment method applied in cases where there is a 3rd or 4th-degree leakage at the valve where deep and superficial veins intersect (safenofemoral junction) according to Doppler results, and when the normal vein diameter has increased two-fold or more. The success rate of this treatment is high when the diameter of the vein in the groin area is less than 7mm. This procedure can be performed under general anesthesia, spinal anesthesia, or tumescent anesthesia. In the procedure, the patient’s vein is located using ultrasound, and access to the vein is provided either through a one cm incision or without any incision, using a catheter from the ankle or inside the knee. Then, the laser probe is inserted from here and advanced to the junction of the deep-superficial veins in the groin (visualized by ultrasound). The vein is closed by burning it from the inside with laser beams. The operation takes about 10 minutes. If there are accompanying other veins, they are also removed with one cm incisions before the operation (phlebectomy). After the effect of spinal anesthesia wears off or about 4-5 hours later, the patient is walked, and on the same evening or the next day, the patient is comfortably discharged by walking.
Variclose (Adhesive) Method
Variclose is another modern treatment method applied in cases where there is a 3rd or 4th-degree leakage at the valve where deep and superficial veins intersect (safenofemoral junction) according to Doppler results, and when the normal vein diameter has increased two-fold or more. General or spinal anesthesia is not required in this method. In the procedure, the patient’s vein is located using ultrasound, and access to the vein is provided using a catheter. A catheter carrying an adhesive substance is inserted from here and advanced to the junction of the deep-superficial veins in the groin (visualized by ultrasound). At this level, adhesive is injected, and the vein is closed. Its advantages include easy application with local anesthesia, ease of application compared to other methods, no nerve or skin damage as it does not create thermal ablation like radiofrequency or endovenous laser, short procedure time, rapid results, and immediate discharge.
