Compression stockings and vein exercises
Compression therapy is an effective method and, in principle, the basic treatment for varicose veins. It is also helpful when other treatment options are out of the question. The veins are compressed with a bandage or a special compression stocking. This allows the blood to circulate better and the pumping effect of the leg muscles is supported by external pressure. Before putting on the compression stockings, it is best to elevate the leg briefly so that the veins empty a little. It is also best to wear the socks when running or doing sport in general.
So-called “vein gymnastics” is also effective. The exercises help against varicose veins by improving the blood flow through the veins:
- Make pedaling movements on the spot.
- First walk on your heels and then on the ball of your foot.
- Grasp and lift light objects, such as a pen, with your toes.
- Bend and stretch your toes.
- Roll your feet from the heels to the toes and back.
Endovenous laser ablation and radiofrequency thermal ablation
Endovenous laser ablation is suitable for the treatment of larger, straight varicose veins, especially the superficial truncal veins. It is not used for severely tortuous and very small varicose veins. It has been scientifically proven that the immediate success rate is more than 97 percent.
The procedure is relatively simple and is performed under local anesthesia. General anesthesia is not necessary. Under ultrasound guidance, the doctor inserts a thin laser fiber into the varicose vein. The vein is closed by the heat produced by the laser energy. Instead of laser energy, electromagnetic waves can also be used to generate heat. In this case we speak of radiofrequency ablation.
The advantages of endovenous laser ablation are
- It can be performed on an outpatient basis
- You do not need general anesthesia.
- No scars are left behind.
- The procedure can be combined with a phlebectomy or sclerotherapy.
- The risk of complications is very low.
Possible complications are Thrombosis (rare), brown discoloration of the skin (usually disappears within a year), nerve damage (rare), pain or minor bruising after the procedure.
Phlebectomy (miniphlebectomy)
Outpatient phlebectomy is suitable for smaller and very tortuous varicose veins. This minor operation is performed under local anesthesia. The doctor removes the varicose veins segment by segment using surgical instruments.
Side effects and complications are rare with this procedure:
- minor bleeding or bruising
- small (millimeter long) scars
- Spider veins in the area of the removed vein
- Damage to smaller cutaneous nerves
- Infection (rare)
Allergic reactions to the local anesthetic, disinfectant or dressing material used are also rare.
Ultrasound-guided foam sclerotherapy
Ultrasound-guided foam sclerotherapy can be used alone to treat larger, tortuous varicose veins or as a complement to endovenous laser ablation.
The doctor punctures the varicose veins 2 to 6 times with an indwelling venous cannula or a fine needle under ultrasound guidance and fills them with a foamed liquid. This fluid spreads through the injected veins and destroys the vein wall.
Complications are rare. The low risk of thrombosis and a possible brown discoloration of the treated veins should be mentioned. This fades or disappears in the vast majority of cases within two years.