Varice membre inferioare

varice membre inferioare - skinmed clinic

Chronic venous disease is one of the most common pathologies, with an aesthetic impact on lower limbs in initial stages and a medical impact in advanced stages.

Onset there occur visible, pinkish, developing blue veins, which can be corrected by laser or injectable therapies and general measures, while in advanced stages they develop changes in tegument (brown coloration), varicose, tortuous, sinuous dilations accompanied by venous lakes and even venous ulcers, with increased risk of thrombosis.

In these advanced stages the therapies are complex, systemic and local, healing is difficult, it is ideal to treat this problem in the onset stages. 

The bilateral venous Doppler ultrasound is the one that establishes the diagnosis and the stage of the disease, along with the local clinical exam.

The most frequently affected by this disease are women, i.e. 90%. Risk factors are sedentarism, obesity, genetic determinism, pregnancy and prolonged contraception in female patients.

The means of prevention of this disease consist of: avoiding sedentary disease, quitting smoking, avoiding obesity, prolonged orthostatism, prolonged exposure to sun, lower limb trauma, knowing that this condition has a strong genetic determinism.

The treatment methods of this disease  are represented by:

Conservative treatment:

wearing compression stockings and administering oral drugs containing Diosminum and Vitamin C 1g - the method that stops disease progression indicated in the early stages of the disease.

Minimally invasive treatment of lower limb aesthetic:

• SCLEROTHERAPY:

minimally invasive treatment method that addresses venectasia and telangiectasis. It consists in the injection of sclerosing agent of different concentrations (depending on the diameter of venectasia), which causes an inflammatory reaction in the vascular endothelium, followed by slow sclerosis of the vessel in about 4-6 weeks, followed by its disappearance. 

Advantages: rapid recovery, no incisions, no anesthesia, rapid mobilization after 2-3 hours. 

Disadvantages: risk of hyperpigmentation at the site of injection, risk of repermeabilization if the Saphenian valvular insufficiency (venous reflux) is not initially resolved.

• TRANSDERMIC VASCULAR LASER:

method of non-invasive treatment of fine telangiectasis, reticular, red or violet telangiectasis. Dye VL or Nd YAG type lasers are the choice for the treatment of visible vessels in their initial stages. 

The principle is selective photothermolysis, laser energy being absorbed by intravascular hemoglobin, with the induction of vascular sclerosis.

Advantages: Fast, non-invasive recovery. 

Disadvantages: risk of hyperpigmentation, painful feeling of hot soreness.

Minimally invasive surgical treatment by radiofrequency or classic ablation.

We can conclude that the method of choice in the surgical treatment of saphenous osteopathic incompetence is crossectomy and stripping (the saphenous vein and all collateral veins are resected) because the risk of recurrence is non-existent if performed in specialized phlebology surgery centers.

Alternative treatments of sclerotherapy and transdermal vascular laser are reserved for cases without venous reflux after the surgical management of venous reflux, or for the cases where we want to improve the aesthetic aspect of the lower limbs.

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