Diagnosis, Treatment and Prevention

Diagnosis of varicose veins

A vascular surgeon takes a proper history and carries out a physical examination based on the clinical symptoms, together with ultrasound, to make an accurate diagnosis, find the cause and provide a customized treatment plan.

Minimally invasive interventional treatment of varicose veins (minimally invasive surgery)

Minimally invasive interventional treatment of reflux in the main trunk veins (the great and small saphenous veins) mainly includes laser treatment (EVLT), radiofrequency ablation (RFA) and venous glue (VenaSeal). By these methods the dilated, refluxing trunk vein is closed, blocking backward flow in the legs and thereby improving symptoms.

This kind of minimally invasive intervention involves a small wound (mostly a needle puncture), is performed under local anesthesia (inner thigh and calf) and allows normal activity right after treatment.

Taking laser treatment (EVLT) as an example: under local anesthesia, the vascular surgeon punctures the great saphenous vein on the inner leg under ultrasound guidance, then passes a laser fiber through the puncture into the vein to close it and block backward flow. Before the laser is applied, the vascular surgeon also injects tumescent anesthesia fluid (TAF) along the inner thigh and calf to ease discomfort in the leg.

A short video from the medfin channel explains laser treatment of varicose veins (click)

Conservative treatment of varicose veins (non-surgical treatment)

For varicose veins with clearly diagnosed great or small saphenous reflux, the fundamental treatment should be interventional surgery, rather than conservative (non-surgical) treatment.

This is because conservative treatment cannot fundamentally solve the problem of varicose veins; at most it can slow progression of the disease.

After interventional surgery, or in everyday leg care, the following are recommended to maintain the treatment effect and reduce recurrence of varicose veins:

• Compression including elastic stockings, adjustable compression stockings and so on
• Avoid sitting or standing for long periods
• Lose weight
• Exercise moderately to build leg muscle strength, plus ankle exercises
• Elevate the legs above the heart, three times a day for 20 minutes each time

Common forms of compression therapy (illustration)