Remove my varicose veins
Delete the varices
The varicose vein’s treatment
The therapeutical’s choice is important from the more invading to the lightest, in all cases we choose the most efficient, the fastest and the most esthetical. In all the circumstances, a sclerotherapy is performed for a complete treatment, then also to prevent reccurencyt. If the largest veins (saphenous veins) are involved, we propose several types of ambulatory surgeries.
The superficial venous surgery:
We only talk about the most recent techniques we use because we consider there are completly correlated to our paradigm: efficacy, fastness, safety, aesthetic.
Efficient and cosmetic : the stripping by invagination or the cryoinvagination
These surgeries are performed under tumescent local anaesthesia completed by neurolept analgesia or, if needed, a short general anaesthesia. The vein to remove is invaginated as a glove’s finger on a string or on a probe. The string is introduced in the vein from the top to the bottom with a guide, then ligated to the vein for removing.
If cryoinvagination is required, the probe is introduced from the groin to the calf stuck to the vein and removed. Non removable bandages added to tumescent anaesthesia allow to prevent the haematomas.
Timing of the procedure: it mainly depends of the veins to remove (generally 1 hour). It can be performed during an ambulatory session or a short hospitalization (24 hours).
The disability is short, from one day to a week. An aesthetic compression is required during 15/20 days.Nevertheless , a reccurency is always possible even in skilled hands.
1 - Invagination on a string
2 - Cryoinvagination on a probe
3 - Pin stripping of short saphenous vein
To avoid the surgery: VNUS Closure and Endovenous Laser Procedure
It is sometimes possible to avoid a too invasive treatment. In this case, we propose techniques that destroy the vein without ablation.
These two techniques are also used for the saphenous vein ablation when they are rather smaller. They are lighter than the classical surgery but they let the varicose vein in situ and a reccurency is always possible on the same vessel.
For us, these treatments are performed when classical surgery seems too heavy or when the patient wish to be operated by these technique. There are performed under tumescent local anaesthesy. In both case, a catheter is introduced in the vein.
With VNUS this probe allows to "cook" the vessel with controlled temperature. When laser power is used, heat is induced by light 810NM energy. In both case, it is the heat that is involved.
When the procedure is finished a compression is proposed for 10 days to have the best result and to avoid post operative inflammations.
Procedure duration : 30 mn for VNUS CLOSURE, 40mn for endovenous laser per leg.
We only perform this technique for great sapheous vein. These two techniques are performed in complete ambulatory session with short disability.
Fast and esthetic : ambulatory phlebectomy
It can be performed for all size of veins. It’s for that reason, it can be preferred to classical surgery, to VNUS or laser on large veins and to sclerotherapy for the smaller one.
We follow the same way for our choice: efficacy, fastness and safety. The veins to extract are previously marked with dupplex scan. The veins to remove are catched through a very small incision with a hook and carefully extracted. Small incisions are closed by strips. Theses scars will completely disappear.
A non removable compressive bandage is applied for one week to prevent haematomas.
We advise to wear an elastic compression two more weeks.
Procedure duration : it depends of the number of varicose veins to remove, one hour for the most part of time. This surgery is performed under tumescent local anaesthesia added with neurolept analgesia in complete ambulatory session. There is few disability .
The mandatory moment :sclerotherapy
All the veins are involved, but for efficacy and aesthetic reasons, we keep this technique for medium and small veins. An irritating product is injected to destroy the venous wall. It provokes a fibrosis then a sclerosis of the vein. This process can last around three months, this explains the mandatory time to wait for results.
This vein disappears within some months. A local compression is sometimes applied to improve the results and to reduce the bruising.
Treatment duration: the session is 20 minutes long, the number of sessions depends of the number of varicose veins to treat .
The venous insufficiency is not a day's disease, it's a life disease.
This is the reason why a phlebologic supervision can be useful to inject rising new varicose veins.
A new evolution for sclerotherapy : the foam sclerotherapy
In this case, the sclerosing agent is not diluted in sterile water but in air.
This allows a very strong efficacy on medium and large veins.
We use this technique with patients with all types of varicose veins, that don’t wish or that fear all types of surgeries (obese people, aged persons, surgical reccurency, etc...). Foam has no interest for spider veins and varicosities.
It must be performed by advanced and well trained physicians.
When the veins are too deep, the sclerosing agent (foam or liquid) can be injected under dupplex scan control (ultrasound guided injections). It requires a double knowledge : the sclerotherapy and ultrasound technique.