The most classic, stripping
Nearly two hundred thousand strippings are carried out each year. This surgical intervention, which consists in removing the main vein of the leg (saphenous vein), has improved: reduced hospitalization time (forty-eight hours most often), possibility of local, loco-regional or epidural anesthesia, more discreet scars thanks to the preoperative marking of the leg which guides the operator’s gesture. This procedure is performed by a vascular surgeon. Two incisions are made, one at the top in the groin, and one at the bottom of the ankle, to tie the vein at both ends. By the lower one is then mounted a tutor who, going back down, takes him with him. The threads are removed on the eighth day, three to four weeks of work stoppage is expected, and sun exposure of the leg is prohibited for six weeks.
For small varicose veins, the “closure” system
This recent technique makes it possible to remove the varicose vein without removing it. Under ultrasound control, a tube is slipped into the diseased vein through a thin incision. Then, the operator deploys the electrodes and “heats” the venous wall over the entire area to be treated: the vein retracts before becoming completely blocked. Local anesthesia is necessary because the high frequency current used brings the temperature inside the vein to 85 ° C.
One morning is enough, and most patients return to work 48 hours later, provided they are not standing for prolonged periods.
The lightest, phlebectomy
This method is especially indicated for treating superficial and moderate varicose veins. Through several micro-incisions, made along the diseased vein, the practitioner passes a hook and extracts it segment by segment. This gesture does not give good aesthetic results in strong people. It is also best to avoid it if the skin does not heal well. Only local anesthesia is needed.
Phlebectomy, performed frequently, can complement other treatment for varicose disease. It can be performed either by the angiologist or by the vascular surgeon.
The most promising, the endovenous laser
This involves sclerosing the diseased veins by sliding an optical fiber inside which delivers a laser beam of a precise wavelength. This is calculated to be absorbed by the hemoglobin of the blood and the venous wall, which avoids the risk of burns around. Under the effect of heat, the vein retracts. In the following days, the varicose veins located upstream also disappear. The treated vein is a little inflamed, hard, and reversible pigmentation may also appear on the superficial veins.
Advantages: no or few scars, little tingling and a reduced risk of recurrence because the procedure causes little inflammation. Local, locoregional or epidural anesthesia is necessary (it gets hot!). Twenty-four hour surveillance in the hospital is advised. Non-traumatic, the laser becomes a real alternative to surgery (stripping) because even large varicose veins can be treated.
More info …
www.gelev.com
(GELEV, Laser and Vascular Ultrasound Evaluation Group).
www.sflm.org
(French Society of Medical Lasers).
