Varicose veins are veins under the skin of the legs, which have become widened, bulging, and twisted.

A good Treatment Plan is based on

  • An accurate diagnosis
  • Detailed evaluation of varicose veins.

The diagnostic evaluation can be organized into 3 levels

  • Level I – History, clinical examination
  • Level II – Duplex color scanning, Plethysmography.
  • Level III –  1. Venography,

2. Venous Pressure measurements

3. Computerised tomography

4. Magnetic  Resonance Imaging

Treatment Modalities

Self care

Lifestyle Change

  • Exercising, ( Read The Need To Move)
  • Losing weight,
  • Not wearing tight clothes,
  • Elevating your legs (Read more: Varicose Veins)
  • Avoiding long periods of standing or sitting

A. Non- Surgical Options

  1. Compression Therapy

They can effectively reduce Edema and Pain

But, their tolerance is questionable.

Recommended Pressure

15 – 20 mmHg  – minor varicosities

20 – 30 mmHg – Moderate to severe varicosities

30 – 40 mmHg- Severe varicosities and Chronic Insufficiency

i. Inelastic Compression Therapy (Unna Boots)

High working pressure during ambulation

No resting Pressure

ii. Elastic Compression Therapy(Stocking)

Sustain compression during both Rest and Activity

Exert graded pressure, Max at ankle decreasing upwards.

Patients should remove them at night

Change to a new one every month

 

iii. Intermittent Pneumatic Compression

Generally reserved for bedridden patients.

 

  1. Leg Elevation

Along with Compression Therapy is – the standard of care

It Mainly

Reduces Edema

Improves Circulation

Hastens Ulcer healing

30 minutes, 3-4 times a day is recommended

B. MEDICINES

Calcium Dobesilate

Pentoxifylline

Aspirin

Micronised Purified Flavonoid Fraction

C. SURGERY

Stripping/Ligation

Echo-Sclerotherapy

EVLTS

– Radiofrequency Ablation

– Steam Vein Sclerosis

Miniflebectomy

TIPP

D. Treatment For Perforator Incompetence

Open Surgery

SEPS (Subfascial Endoscopic Perforator Vein Surgery)

ENDO VENOUS THERMAL ABLATION

LASER ABLATION (EVLT)

One of the most popular Treatment Modalitiy for Suprficial Venous Incompetence.

It uses Thermal energy to ablate the Great Saphenous Vein(GSV)

Usually, Doppler scan Guided procedure.

Advantages

  • Minimal Invasive Procedure
  • Minimal Discomfort
  • Least disruption of daily activity
  • Performed as a day care procedure
  • Excellent safety profile

Recurrence after EVLTS is usually due to

Perforator Veins

Recanalised Great Saphenous Vein.

New Anterior Accessory Great Saphenous Veins

RECURRENT VARICOSE VEINS

Varicose veins are associated with high recurrence rates.

Many factors are responsible for this

Inaccurate Diagnosis

Inadequate Surgery (Early Recurrence)

Neovascularisation (Late Recurrence)

Increased disease severity (Progression)

Prolonged Standing

Deep Venous Thrombosis(DVT)

2014 © Copyright -AmritaClinics | Made with by Foxpro Inc.

For emergency cases        +91-98155-01218