Vein surgery deals with the treatment of venous diseases.
90% of all treatments are for chronic venous insufficiency (CVI) of the lower limbs, which leads to varicose veins. Varicose veins are caused by the widening and lengthening of the superficial veins.
The veins of the lower limbs are divided into two vein networks.
One of the vein networks is called the deep vein network. It is located in the middle of the muscles, is directly connected to the arteries and provides 90% of the venous return. Venous return, or venous return, is the return of blood to the heart.
The second venous network is the accessory, superficial venous network. Its task is to drain the skin and subcutaneous tissue. In contrast to the deep venous network, it is responsible for only 10% of venous return.
The venous system is responsible for the return flow of blood to the heart. The latter depends on numerous factors such as:
To date, the cause of varicose veins has not been clarified. However, varicose veins are five times more common in industrialised countries today.
There are, however, predisposing (favouring) factors:
There are few or no symptoms of varicose veins. A distinction is made between clinical symptoms and aesthetic problems.
Clinical symptoms of problems caused by varicose veins:
Aesthetic problems are often the main concern, as the varicose veins are very conspicuous on the leg and the sight of them disturbs the patient, as well as causing psychological problems.
During clinical diagnosis, patients are classified according to CEAP. The CEAP classification is the classification of the severity of chronic venous disease.
During the diagnosis, the doctor will conduct a detailed interview. During the interview, the history, especially the family history, the favouring factors, the various complaints of the patient and the concomitant diseases are determined. A complete examination of the lower limbs is also carried out, during which venous ultrasound is performed. In the case of pelvic insufficiency, the examination is carried out with the help of phlebomagnetic resonance imaging (MRI).
If varicose veins are not treated for symptoms, the following complications can occur.
In the skin area:
If inflammation (phlebitis) of the superficial veins occurs, there is acute local pain and the varicose vein becomes inflamed.
In conservative treatment, there are several rules that affected people must follow. These include
Treatment also includes compression therapy, using special socks, stockings or tights.
Surgery is considered when conservative measures can no longer relieve the symptoms sufficiently. Complications such as leg ulcers occur, or varicose veins put a mental strain on the person affected.
Today, various treatment methods are available.
A total of two incisions are made below the groin and in the hollow of the knee, or ankle. First, the vein is tied off or clamped at the upper incision (so-called vein ligation). Then a long wire is inserted through the lower incision into the vein and advanced. A button-like attachment is used to pull the vein out of the groin.
When a phlebectomy is performed, several small incisions of a few millimeters are made along the affected vein. Using small hooks, the vein is pulled out through these incisions as far as possible. The vein is then cut and removed in several pieces.
In laser therapy or radiofrequency therapy, the vein is destroyed by the application of heat. The treatment is done under local anaesthetic and is relatively painless.
Chemical sclerotherapy is a minimally invasive and outpatient procedure in which varicose veins are treated with the help of ultrasound or special sclerosing agents. The treatment usually requires several sessions and can be performed individually or as a complement to varicose vein surgery.