Surgical Interventions
There are many surgical procedures to eliminate varicose veins, but all of them involve in general the radical suppression of the damaged superficial venous network through the removal of the highest number possible of varicose veins. These are the main procedures:
Endoluminal laser treatment: This treatment is an alternative to conventional surgery to treat 2-3 mm varicose veins and larger. It is generally done using local anesthesia and involves the introduction of an optic fiber catheter (a 3 mm tube) inside the affected vein, controlling its closure with the heat produced by the laser. For these kinds of varicose veins, transcutaneous laser is contraindicated since the amount of heat needed to remove them would burn the skin. Due to its characteristics, this treatment is appropriate for people with recurrent varicose veins, patients with clotting problems and older people or with a specific medical history that would not allow rather long walks. The surgery takes an average of 30-45 minutes. Once finished, a pressure bandage or elastic stocking is placed to compress the operated areas.
Phlebectomy: It is usually practiced on patients with varicose veins at an advanced stage (sometimes, according to each case, this treatment needs to be complemented with sclerotherapy for lower sized varicose veins). The surgery involves the elimination of the dilated veins through little incisions of no more than 2 millimeters made with a phlebectomy hook inserted under the skin surface to remove the varicose vein. The recovery period, as in all treatments, is indicated by the physician and depends on the characteristics of the treated varicose veins, but it is necessary to use graduated compression stockings for approximately two to three weeks after surgery.
Saphenectomy: It is the removal of varicose veins compromising the saphenous axis and their surroundings through a total or partial excision of a saphenous vein. The procedure involves epidural anesthesia and it consists of minimal incisions. Hospitalization for one day is required. This procedure is also used to obtain vein grafts in aortocoronary interventions.
Hemodynamic CHIVA surgery: CHIVA is the French acronym for Conservation and Hemodynamic cure of Incompetent Varicose veins in Ambulatory patients”. Through this procedure, blood is redirected without removing the vein. First, a Doppler study is conducted in order to determine the strategic areas facilitating the appearance or permanence of varicose veins. After this study, such areas are operated using local anesthesia. It is a simple, ambulatory surgery – approximately 30-45 minutes – that brings excellent results.
