Spider veins, varicose veins: when do we remove them?

Health limaopreto July 25, 2016 0 528
Spider veins, varicose veins: when do we remove them?

Dilated veins just aesthetics. Sclerotherapy, laser, radiofrequency surgery: focus on the different treatments to get rid of varicose veins.

 Contents of this article
  •  Venous disease is progressive
  •  Foam sclerotherapy based poised to dethrone surgery
  •  Heat: of endovenous techniques that develop
  •  Surgery: a day at the hospital for stripping

When blood circulates badly in the legs, the small vessels become congested veins to form a network around the ankles and calf. These veins do not necessarily herald the appearance of varicose veins. In France, from 20 to 35% of the population suffer from it. In almost half the cases, the saphenous vein, which runs from the ankle to the groin, is affected.

Varicose veins form on the weakened veins distended, the valves to prevent the blood back down, begin to flee. A review coupling an ultrasound Doppler direction of a vascular physician assesses blood flow. "The Doppler is fundamental. The visible signs on the legs is sufficient to assess the condition of the veins, "insists Dr. Claudine Hamel-Desnos, president of the French Society of Phlebology.

Venous disease is progressive

Different techniques are used to remove varicose veins and spider veins. But venous disease continues to evolve and may recur. That is why we must weigh the benefit of an intervention with his doctor, and choose the most suitable method. The stage of disease is the main criterion, varicose veins may be complicated by leg ulcers. The patient's age is important. So it is better to avoid the heavy techniques such as surgery in the elderly and in people under thirty.

Stripping, method of surgically removing the saphenous vein, though slowing, is still widely practiced. In general, surgery seeks to be softer. When possible, the main trunk of the vein is preserved and the surgeon removes only the diseased branches.

Today, we prefer the saphenous sclerosis or burn from within. These are the laser and radiofrequency that present the least risk of recurrence. But they are still little developed in France. Less than 500 practitioners are trained.

Remove the saphenous vein: what consequences?

Saphenous part of the superficial blood network which provides only 5 to 10% of the venous circulation of the leg. The deletion has limited consequences and do not mind the deep network which itself provides most of the blood flow. However, the trunk of the saphenous vein can be used in cardiac surgery for bridging. Removing it is not completely trivial. It must be done wisely.

Foam sclerotherapy based poised to dethrone surgery

Increasingly widespread, it is poised to dethrone the surgery.

For who ? "It is a versatile technique to treat varicose less than one millimeter in diameter to the saphenous" said Hamel-Desnos Dr.

How it works ? Sclerosing foam is injected into the vein using a needle. It will destroy the inner wall. No need for anesthesia. Each session lasts fifteen to thirty minutes. Blue or pigmentation may appear transiently in the path of the vein.

Or ? The injections are the office of a vascular physician. The patient left immediately, without work stoppages.

What a refund? Sclerotherapy is reimbursed at 65% by Social Security for varicose veins, but not for spider veins.

Heat: of endovenous techniques that develop

The development of laser and radiofrequency is recent in France.

For who ? "These are the best techniques for treating saphenous, but they are sometimes difficult to use on some very tortuous veins," says Hamel-Desnos Dr.

How it works ? A catheter is introduced into the vein under local anesthesia by puncture below the knee. This allows to pass either a laser or radiofrequency probe that, under the effect of heat, will cauterize the vein. The gesture is guided under ultrasound.

Or ? These techniques "endovenous" are performed in the hospital or clinic. The patient immediately apparent. There is no need to work stoppage.

What a refund? Social Security reimburses radiofrequency since late 2014. For the laser, only the clinical part that includes the use of the hardware is supported, not the doctor's fees.

Surgery: a day at the hospital for stripping

The number of surgeries for varicose veins decreased by 16.5% in France between 2007 and 2012.

For who ? According to the recommendations, the stripping should be limited to certain cases of varicose saphenous.

How it works ? Under general or regional anesthesia, the surgeon makes incisions in the leg and in the groin. It will then ligating the saphenous vein and remove.

Or ? The surgery is done in the operating room. In 80% of cases, the patient leaves during the day. He must wear compression stockings four to six weeks to prevent phlebitis.

What a refund? The transaction is refunded.

The average length of the work stoppage is 26 days.

Treat varicose veins in the summer or winter? There is no rule. But, bruising may persist on the treated leg for ten days. Not easy to get in miniskirt ... Sun exposure is never good for the skin, much less scarring.