The lower limbs have a redundant venous system consisting of peripheral and central venous pathways. It is therefore possible to eliminate a varicose peripheral vein without causing major damage.
Historically, in phlebology, stripping surgery has been the standard treatment for saphenous varices, but the development of endovascular treatments has profoundly changed the situation.
Currently, instead of removing the vein, so-called "endovascular" techniques exist to destroy it "in situ". This procedure is performed sometimes with the aid of fibrosing foam injection, sometimes by heat-induced cauterization of a laser beam or a radio frequency current.
The endovenous techniques
Endovenous techniques present, in the long term, results that are equivalent to those of conventional surgery. In addition, the risk of recurrence remains low. However, they are not indicated in case of a pathology affecting the superficial veins.
Radiofrequency occlusion, laser thermocoagulation and sclerotherapy are such techniques.
This method consists in heating the interior of the vein by electric current. Either the current heats up a resistance like that of a traditional light bulb, or the ionic vibrations induced by a radiofrequency current cause the heating of the venous wall. More details here
The intense light produced by a laser is guided using an optical fiber that is thin enough to be introduced into a varicose vein. More details here.
Sclerotherapy is one of the ablative endovenous techniques. It consists in injecting a sclerosing product into a varicose vein to disable it. Under the effect of the sclerosing product, the varicose vein will close and become a fibrous cord. The goal of sclerotherapy is to slow the course of the disease by putting out of operation the abnormal varicose veins in the venous circuit. There is no need to fear a lack of veins after treatment. Indeed, it concerns only abnormal superficial veins and not the deep veins (main venous system). More details here.
The vein stripping technique
Stripping (varicectomy) concerns large veins: this method involves removing the saphenous vein. It is performed under general anesthesia or under rachi-anesthesia. The intervention requires hospitalization of very short duration, typically one to two days. Walking is possible the next day but requires the wearing of compression stockings. A work stoppage of 3 weeks is usually prescribed. More details here.
TVC Medical has developed, in association with UneInfirmiereChezVous, a Wound Care Protocol to optimize the healing of ulcer wounds resulting from a situation of venous insufficiency.
The protocol considers different parameters: the general state of health of the patient, the severity of the wound, etc.
Our nursing corps is trained in the different techniques documented in the Protocol of Care. The implementation of each of them depends on the situation encountered. As an example, we refer to the results obtained in the treatment of a venous insufficiency ulcer over a period of 4 months, from May to September 2018: here is the link.