 Varicose veins
The condition for best treatment possible is the specification
of correct diagnosis. The general state of health is diagnosed during
the initial consultation. The vascular system of the lower limbs
is thoroughly examined ( i.e. the arteries, deep and superficial
veins) clinically at first and subsequently by duplex ultrasound.
On the basis of these examinations the appropriate treatment is
recommended. This is built on the basis of the combination of a
variety of forms of conservative and radical treatment.
90 % of varicose vein (varixes) diseases are hereditary diseases
tied to the genetic code. It is possible to provide cosmetic treatment
of all pathological veins, however it is not possible by forms of
present medicine to, alongside with the varicose veins, get rid
of the desease itself which is for life. This is why the preventive
and conservative method is suitable to rely on in the future, even
though the varicose veins themselves have been removed.
What does the conservative method consist of in the treatment
of varicose veins?
a) In the wearing of compressive elastic medical tights whose
length and level of compression we determine ourselves. You can
also obtain them at our clinic. They are made to measure and we
recommend you try them on after making an appointment with the nurse.
If we recommend an operation, the daily wearing of tights till the
time of the operation is the best prevention of possible complications
as for instance veinal inflamation. You can wear these medical tights
even after the operation although they do not have to be worn regularly.
They should be worn when undertaking static positions such as standing
or sitting and during a period of a several of days before and during
menstruation. They are also suitable after sclerotisational treatment.
b) Medical treatment is another possibility of conservative approach.
Nevertheless it is necessary to realise that no medicine in whatever
form is able to destroy, or cure varicose veins. We provide medicine
medically in the case of problems and pain and with the inflamation
of veins. We indicate various medicine after the treatment of varixes
as a medical preventional remedy. These are most suitable during
the summer seasons when the warm weather prevents the wearing of
medical tights.
Radical treatment
Radical treatment is the most effective and only way how to get
rid of varicose veins. Having the general state of health of the
patient in mind, this method is possible at any age.
What does our method consist of?
It is a method which is able to treat varicose veins of the largest
and smallest on the scale. The basis of this treatment is an operation
supplemented with sclerotherapy and laser therapy. The mini-invasive
operational technique comes from the original CHIVA method (Paris
1988) which has been modified at the clinic throughout the years
and adapted to the veinal misfunctions of our population. It seeks
to treat all unnecessary pathologic veins which will not be of loss
after the operation. All healthy veins are left in tact.
The varicose veins are tied, shortened or removed from the body
through 1–3 mm incisions on the basis of duplex ultrasound treatment
which is provided shortly before the operation. The strangling of
varicose veins has to be done with milimetre accuracy in the main
areas of origin of the varicose veins. Mainly, the treatment of
the deep veinal system is of concern.
The EVLT Laser
It is possible to use the laser for the curing of the origin
of widespread varicose veins in certain special and strictly chosen
cases of disability.
The principle lies in the following: A special thread with a
laser device on the end of it is pushed into a once functional pathological
vein. This laser literally smolders the misfunctioning vein. Because
of its lack of flexibility, the thread is unable to get into all
the entagled veins as is in the calf area, it is possible to combine
this method with surgery.
Every operation individually depends on the span, amount and
degree of harm and disfunction of the veins. It can be said that
the treatment is made for the patient.
An experienced anaesthesiologist is present during every operation
to guarantee the patient a painless and smooth operation and security.
This is the main condition when operating. Methods of combined ambulant
anaesthesiology (not exhausting the patient) are used. They are
based on intravenous application of medicaments of ultrashort effect,
specially devised for the needs of ambulatory anaesthesiology.
Thanks to this, it is possible to go home after the operation.
Every patient is informed about the form of anaesthesiology before
the operation. The removing or minimalization of negative side-effects
such as vomitting, insomnia or headaches is a great contribution
to ambulatory anaesthesiology. It does not leave any side-effects.
The program for the prevention of trombosis and embolia.
Varicose veins are one of the causes of trombosis and embolia
and are complicated by these processes. This is why one of the basic
preventions is their operation.
Complications of untreated varicose veins
Varicose ulcer Hyperpigmentation
What does this program consist of?
precise ultrasound scanning of superficial and deep veinal system
directly before the operation
a thorough pre-operation checkup with laboratory results of correct
blood coagulability
the correct doseage of medicine which reduces such a risk before
and after the operation (blood diluting)
the mini-invasive technique of operation provided during one-day
surgery
special ambulant anaesthesy which enables immediate body movement
after the operation
the high quality bandage of non operated limbs to the next day
This is the maximum that can be done and more is not possible.
The priorites of this form of treatment
Aiming for the correct form of treatment or its combination with
a broad scale of possibilities, for we use all forms of treatment
and thus are not left to rely on simply one of these forms
Emphasis is given to the radicality of the operation (the total
removing of all pathogenic veins) and the longevity of the result
The cosmetic effect of laser treatment
A painless course of both the operation and post-operational
period
A program that reduces the risk of trombosis, lung embolia and
hospital infections
An ambulatory intervention with the possibility of returning
home at the day of the operation
No, or minimal, working disability
Sclerotisation
With veins of smaller circumference than 1 mm (microvarixes)
we recommend sclerotization treatment. By injecting a special substance
via thin needles directly into the veins themselves, the veins begin
to gradually absorb themselves. This form of treatment is used as
a supplement to the operation and is performed during or sometimes
directly after the operation, depending on the circumnstances.
We recommend sklerotisation for patients with isolated locations
of only the smallest of veins. After such an operation we recommend
wearing elastic tights of II. compressional level which we specify
according to the span of the affected area.
It is possible to notice dark patterns in the area of the subtle
veins. This pattern is caused by the pigmentation of pathological
veins. The pattern will become highlightenned after sclerotization
however it shall disappear only after a short period of time (simultaneously
with the healing abilities of the organism). In 5–10 % of cases,
these pigmentations stay in the form of maps for a longer period,
or even forever. Nevertheless, sclerotization is suitable for cosmetic
reasons and as a prevention against further uncontrolable spreading
of microvarixes.
Laser
With the subtlest veins (“cobwebs”) the best effects are with
the laser. The “sclerolaser” is the last in the line of treatment
methods.
Every type of deffect of superficial veins has a precisely given
form of treatment. In the case of varixes suitable for operation,
the sclerotisation method is unsuitable, because it does not have
the required cosmetic effect and is afflicted with a 100% relapse.
It harms the patient in the way that it is impossible to provide
successful operation in the areas of sclerotisation. Laser therapy
also has little or no effect when treating veins of larger size
than it is able to cope with.
All radical forms of treatment – operation, sclerotisation, laser
therapy, if sufficiently provided, are not methods of competition,
but when used in combination, form excellent results.
This is why we recommend you to choose with caution a clinic
that has long term experience with the treatment of varixes and
which regularly manages to gain positive results. The ability to
provide treatment in its whole scale of possibilities, to provide
all forms of treatment (sclerotisation, laser, operation) is also
highly important. One should also have in mind whether the clinic
does not rely on only one form of treatment which it would preffer.
The treating of relapses and repetitive varixes after insufficient
treatment of operational, or sclerotisational form is much more
difficult and complicated.
| 
