Lower limb varicose veins
Phlebology is the branch of medicine concerned with the diagnosis and treatment of venous diseases, one of which is varicose veins. Lower limb varicose veins are a common condition in many people. Some patients, despite preventive measures and pharmacological treatment, require surgical intervention. If varicose veins are small and confined to minor veins, they can be closed by injection of a sclerosing agent (sclerotherapy) or by local excision through micro-incisions under local anaesthesia (miniphlebectomy). In the case of large veins, the phlebologist will most likely recommend a procedure — most commonly the removal of the great saphenous vein (the large vein of the superficial venous system). During the operation the phlebologist makes 2 small incisions in the groin and at the foot, as well as micro-incisions over the varicose veins (these do not require sutures). This type of phlebology procedure is performed under general or spinal anaesthesia. The clinic stay is one day.
Before the surgery:
Before sclerotherapy or surgery, an ultrasound examination of the venous system (echo-Doppler) is required for accurate diagnosis and procedure planning by the phlebologist. A consultation with the surgeon and anaesthesiologist is necessary, during which the type and date of the procedure are determined and the required pre-operative tests are ordered, as well as the type of anaesthesia decided.
Telangiectasia (“spider veins”)
Telangiectasia, commonly referred to as “spider veins” or burst capillaries, are simply small varicose veins. They are often the first sign of larger varicose veins that may appear in the future, or they accompany already visible varicose veins. The most important principle followed by a phlebologist is thorough diagnostic assessment of the venous system before treatment (echo-Doppler), as larger varicose veins typically “feed” the smaller ones and should therefore be treated first. Small telangiectasia can be closed with a laser; slightly larger ones require sclerotherapy. Both procedures are performed without anaesthesia as they are virtually painless. After the procedure, anti-varicose textiles (stockings, tights) should be worn for several days. On the first day after sclerotherapy, the leg is bandaged. The effect of both laser treatment and sclerotherapy is visible after several weeks. In most cases, a single procedure is not sufficient for complete elimination of telangiectasia, especially if they are very extensive.
