Medications for varicose veins

Among the treatments that the doctor prescribes when the varicose veins are not serious there are the phlebotonic medicines, that is, medicines that strengthen the walls of the veins. 
For leg veins, usually the prescribed medication is diosmin (Diosmin).

 

Creams for varicose veins

Creams may help reduce symptoms, but one should be careful with the gel because it is usually alcoholic based, it soon tends to dry the skin. 
This can increase the itching .

 

Goicoechea

It is a  cosmetic , not a medicine. 
Goicochea cream has the following ingredients:

  • Asian spark,
  • Elastin and collagen,
  • Bulbs,
  • Horse-chestnut,
  • Color.

Natural ingredients stimulate blood circulation and reduce the sensation of heavy legs. 
To see results, apply at least 3 times a day for at least 3 months . 
Goicoechea is a cream that costs between $ 29 and $ 35 per 400 ml of product.

 

Venalot h

Venalot H improves peripheral venous and lymphatic circulation, relieves:

Contains:

  • 5 mg/ml (cumarina),
  • 50 IU / ml (sodium heparin).

Contraindication of Venalot

Venalot should not be used in the event of:

  • Allergy  to the components of the formula.
  • Serious problems with the liver.

 

Varicell Cream (300 g bottle)

Varicell Cream reduces:

  • Tingling sensation
  • The pains,
  • The feeling of weight in the legs.

Varicell leg cream relaxes and moisturizes the skin, so it is suitable for all skin types. 
Apply the cream twice a day (morning and evening), preferably after bathing. 
Price: between R $ 44 and R $ 50.

Elastic compression stockings

Graduated compression stockings greatly help the venous return. 
This sock should tighten a lot at the level of the foot and less at the top of the leg. 
In this way, it squeezes the arteries at the bottom and blocks the venous return towards the foot. 
The only problem is that it gets very hot, so in summer it’s hard to bear .

In addition, they should be customized, otherwise they may cause wrinkles to form that worsen the problem. 
According to a study by Hirai M et al. (Department of Surgery, Aichi Prefectural College of Nursing, Tougoku, Kamishidami, Moriya-ma-ku, Nagoya, 463-8502 Japan), elastic stockings prevent the development of swelling in people suffering from varicose veins .

However, the minimum pressure should be 22mmhg for a better result.

 

When to operate the varicose veins?

The operation is indicated:

  • If the person has symptoms that do not go away with the treatment,
  • For imperfection.

In addition, it is performed to avoid complications such as:

Patients are often concerned about the possible consequences of vein removal . 
In the lower limbs there are deep veins that are connected to the superficial veins through a dense network of “piercing veins”. 
Thus, removal of a superficial vein does not block venous return .

 

Varicose veins

Laser surgery for varicose veins

Laser surgery consists of the transmission of a laser beam that “burns” the inner walls of the vein:

  • Safena magna or great saphenous,
  • Silly or saphenous saphenous.

The laser is very accurate and only affects the affected area. 
This therapy creates fibrosis in the blood vessel and, within a year, the vein disappears due to atrophy.

The intervention is only irritating or painless because it does not involve surgical incisions, but only a small cut to insert the laser fiber (very thin) .

Description of the intervention

  • The doctor performs a local anesthetic with small injections,
  • The fiber is inserted at the level of the knee and advances to the groin.
  • To correctly position the fiber in the vein, the insert is guided by ultrasound,
  • At the end, the patient returns home with elastic stockings.

The intervention is performed in a hospital and can last from 15 to 20 minutes.

Contraindications
This therapy can not be performed in superficial veins because it can cause  skin burns due to heat. 
The vein should be quite straight, otherwise the laser fiber can not pass.

After the operation , the patient is well:

  • There is no post-intervention convalescence,
  • You can perform daily activities immediately.

 

Surgery for varicose veins

In 20% of cases where laser surgery is not indicated because veins are superficial, the surgeon may suggest stripping.

The saphenous removal surgery is done less and less because:

  • There are less invasive techniques that give better results,
  • The saphenous vein may be helpful in case of cardiac surgery.

The phlebectomy (the first was at the Mayo Clinic in 1924), or the removal of a vein, is carried out in day hospital. 
With this technique, all varicose veins can be eliminated, except for the large saphenous vein that requires a different treatment: crossectomy. 
In this case, before removing the vein it is necessary to make an incision and ligation of the joint between:

  • The saphenous vein and the femoral vein,
  • The saphenous vein and the popliteal vein,
  • The collateral (tributary) veins.

Description of varoneal phlebectomy surgery

  1. The operation is performed under local anesthesia.
  2. Instead of making cuts, some small holes are made on the skin with a needle or a very thin blade at the points where the varicose veins are most protruding.
  3. Then the surgeon inserts a catheter and an instrument called a stripper into the vein to the lower end, below the knee.
  4. From here, pull and pull the vein.

Post-intervention recovery

  • The surgeon places a compression bandage and the elastic stockings,
  • For 3-4 days, do not get up.
  • For full recovery, 2/4 weeks are required.

According to an article published on varicoseveins.org , stripping has a success rate of 71%, while less invasive therapies reach 98%.

 

Sclerotherapy for varicose veins

It is a simple procedure that does not require hospitalization. 
During this treatment, a solution is injected into the affected veins with a fine needle.

According to Parsons ME . (Sclerotherapy basics, Dermatol Clin 2004 Oct. 22 (4): 501-8, xi.), The substances used to close the veins are:

  • Soap  – destroys the cellular membrane of the veins (causes denaturation of proteins)
  • Osmotic products – cause cell dehydration and protein denaturation.
  • Chemical irritants – destroy the endothelium of the vein.

The most commonly used substances are:

  1. Hypertonic saline solution,
  2. Tetradecyl sodium sulfate,
  3. Polidocanol,
  4. Chromium glycerol.

The injection can cause discomfort for one to two minutes, especially if the vein treated is large.

Indications
The ideal candidates are people with superficial veins and small caliber (less than 5mm). 
Pregnant women can not do sclerotherapy.

Side effects vary:

Today sclerotherapy is used with the foam: a sclerosing mousse . 
In this procedure, the sclerosing liquid is mixed with air to create a foam that is injected into the veins.

It is used in large varicose veins, at least 20mm because the foam moves all the blood mass of the varicose veins. 
The liquid is instead diluted. 
It is not made in medium or small veins, otherwise the mousse can give more important reactions (hematoma, etc.)

This is one of the easiest ways to relieve varicose vein pain.

Three syringes are used:

  • One with a physiological solution to “flush” the vein, remove the red blood cells and increase the effectiveness of the medicine.
  • Two more for the injection of the drug (for example, Ethamolin®).

After sclerotherapy , the elastic stockings should be used to keep the drug in contact with the venous wall. 
bruise / bruise forms . Depending on the size of the vein, they may be small or large.

 


TRAP therapy for varicose veins

Sclerotherapy acts on the affected superficial veins, but does not intervene in the cause, then:

  • You can not avoid relapses,
  • There are complications.

Regenerative three-dimensional regenerative phlebotherapy (TRAP) is a “gentle” and non-obstructive form of sclerotherapy that acts throughout the venous network:

  1. Superficial,
  2. Perforating veins (which connect the superficial and deep circulation).

This treatment allows regeneration, so do not block the vein. 
The surgeon injects a solution of 6% sodium salicylate and 0.5 or 1 ml of lidocaine hydrochloride in an alkaline carrier in all visible vessels:

    1. With the naked eye,
    2. By transillumination.

According to scientific studies , the esthetic result is better than the other treatments, even after 6 years. 
Sodium salicylate has an effect:

  1. Anti-inflammatory,
  2. Anti-coagulant.

The alkaline pH of this substance has 3 effects:

  • It reduces the absorption of salicylate,
  • It neutralizes your metabolism products,
  • Accelerates the elimination of this substance.

The viscosity of the solution:

  • Decreases the dilution of the drug,
  • It allows complete contact with the endothelium (inner wall). This characteristic is lacking in normal aqueous sclerosing therapies except foaming.

In the case of moderate varicose veins, in one session the surgeon treats the entire lower limb, in other cases, in each session it treats only one region:

  • Medial or internal,
  • Posterior,
  • Lateral.

If this treatment is performed correctly, there are no side effects.

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