Surgical cure (classic surgery)
Microsurgery phlebectomia (removes only vein dilatations)
Laser treatment of varices and teleangiectazia.
Varix is one of the most frequent affection in human pathology, which beside the fact that it is disgraceful, it may also cause serious complications, such as thrombo-phlebitis or shank ulcer. Thus, the earlier we diagnose the illness, the better the operating results are.
The first signs of the illness can be noticed at shanks, causing discomfort – cramps, discreet numbness, heavy shank, passing oedemas.
When the varices are already formed, we can notice dilated, winding vein columns, which become more and more dilated.
There is a type of unaesthetic varix which does not cause any pain, in which case the unaesthetic aspect is on the first place. These are teleangiectazia, intradermic varices, venectazia, reticular varices.
Treatments used in all cases depend on the clinical aspect of varices and include removal the varicose parcels through microsurgical techniques, with incisions which shall become actually invisible after a few months from the surgery, laser-therapy and sclero-therapy.
Modern society tends to give aesthetic problems an equal value with functional problems and cutaneous injuries due to vein insufficiency.
Functional results and aesthetic results have to be equal in case of varices.
Types of anesthesia: rachidian, peridural, local, general (if the patient wants it or if the anesthetist indicates).
Surgical technique : the varix must be drawn on the patient skin for an easier revealing and surgical treatment of dilated veins.
The incision from the inguinal flexion groove, and from the femoral triangle, respectively, of about 1.5 cm, uncovers the safena crossa and cholaterales which will be tied. In some cases, the safena may be extirpated at level of the thighs until under the knees, but in other cases it is left in place (after tying).
In case of varices of the shank, we make mini-incisions approximately 1-2 mm which are exteriorized with Muller crest and tied, respectively interrupted between ties.
Post-operator, we apply an elastic bandage or elastic stockings for 7 days.
Laser treatment: basic requirements for venectazia treatment:
a) wave length adequate for maximum absorption in hemoglobin
b) penetration depth until the anatomic level of the vessel
c) sufficient power to destroy the vessel, without destroying the surrounding skin (it should not have another chromofor)
d) action time has to be long enough to allow slow coagulation of vessel.
Parameters on which depends the efficiency of the treatment are: wave length, pulse time and spot diameter.
Larger diameter of veins require a longer pulse time for a gradual coagulation of the entire vessel.
With laser (depending on its type) can be treated vessels of small dimensions from 0.1mm up to max. 1-5 mm that are located at depths up to 3-5 mm. The operating principle of laser: selective photo-thermolization and photo-coagulation.
In case of vascular injuries the light is absorbed in the target chromofor, that is in the hemoglobin from the vessels.
When the temperature is high enough, the hemoglobin from the vessels coagulates, removing a vein segment.
For teleangiectazia the most appropriate wave length are between 500-600 nm.
The laser used in our clinic is produced by ASCLEPION MEDITEC, and uses copper – chromid vapors.