Venous insufficiency is a condition that progresses clinically from superficial vascular enlargement to swelling and wound opening in the leg with the enlargement that occurs due to the deterioration of the valve structures in the vessels carrying blood to the heart, and the resulting increase in blood pressure in these vessels.

The basic examination in the diagnosis is Venous Doppler Ultrasonography.

If you have the above-mentioned signs, you will become a candidate for treatment by confirming the diagnosis with an ultrasonography procedure that takes 15 minutes. Compression stockings, drug therapy and surgical methods  (ligation, ablation, mini-phlebectomy, etc.) are at the forefront of the treatment.

 

SURGICAL METHODS

HIGH LIGATION

It is a procedure that is mostly applied in two regions on the legs. These regions are in the groin and behind the knee, and the reason for this is to prevent the blood from pooling in the superficial system by cutting the connection of the vessels developing here with the deeper main venous system.

Sometimes the entire leg, or partly, of this superficial vascular structure can be removed.

 

STRIPPING

It is a 30-45 minute procedure performed with local anaesthesia, and the patient is discharged on the same day after being followed up for a few hours.

 

Mini-phlebectomy, which is the process of removing varicose veins with superficial vasodilation, by entering through 1 mm holes, is applied to the procedure.

The process after the operation must pass with no problem for the patient and the incision site must be taken care of for a few days. The patient can return to her/his normal business life after 1-2 weeks.

 

ABLATION

Thermal ablation methods are mostly performed with technology-assisted catheters such as laser and radiofrequency.

The main purpose of these methods is to insert the vessel sheath by entering the great saphenous vein and the small saphenous vein, where venous insufficiency is most common, with a needle accompanied by ultrasonography, and to close a partial segment of the vessel by placing a special laser or radiofrequency catheter through this sheath.  The advantage of this technique is that no incision is made and a short time to return to normal life. However, although local anaesthesia called tumescent anaesthesia is applied during the procedure, patients mostly need sedation, regional anaesthesia or general anaesthesia. This may prolong the patient's post-operative stay.

The basic method used in non-thermal ablation methods is the adhesive ablation method. In this method, a large or small saphenous vein is entered under ultrasound guidance with a special

catheter, and a partial segment of these vessels is closed with an adhesive (N-byte- cyanoacrylate) compatible with human tissue, and the pressure and insufficiency in the superficial veins are eliminated, and the patient's signs are eliminated. Again, mini phlebectomy or perforating vein ligation can be added to this method, making the treatment holistic.