Elimination and treatment of varicose veins

Overview of the possible treatment for varicose veins

While spider veins are regarded as a cosmetic problem, you should take large varicose veins seriously, as they may give rise to serious complications up to the point of thrombosis. From the medical point of view, varicose veins need to be treated if they cause symptoms and/or impair the circulation – for example, when blood flows back in the wrong direction. This is usually the case with varicose veins of the trunk veins, side branch veins, and perforating veins, so they should be treated promptly.

One thing you should be absolutely clear about: no treatment can cure varicose veins for ever. The hereditary connective tissue weakness, i.e. the tendency to develop varicose veins, is present throughout your whole life and certain risk factors, such as advancing age, cannot be overcome. Even after varicose veins have been successfully treated, new ones may develop over time at the same site or elsewhere, and require further treatment. Nevertheless, you can and should do something against the disease. Today’s methods of treatment can manage varicose veins and prevent the sometimes serious complications from developing.

Which method of treatment is the best for you?

Surgical procedures are widely used in Germany, where some 300,000 inpatient varicose vein operations are carried out in hospitals each year. Many people are frightened of a general anaesthetic, of the surgery itself, or of postsurgical pain. Today there are alternative, minimally invasive methods of treatment for every type of varicose veins, which can be carried out without general anaesthesia through relatively small skin incisions or, in the case of foam sclerotherapy, without any anaesthetic and incisions at all.

These modern procedures for the treatment of varicose veins are called endovenous procedures.
They include thermal procedures, in which the diseased vein is burned and obliterated by heat using radiofrequency or laser energy. Radiofrequency ablation and laser therapy do not require a general anaesthetic, but are usually carried out with tumescent anaesthesia (a special type of local anaesthesia). As tiny incisions are necessary, some doctors still count them as surgical procedures.
Foam sclerotherapy is also an endovenous procedure. A foam sclerosant is injected into the varicose vein to obliterate it. No anaesthesia is required.

The latest studies on the treatment of trunk varicose veins show that all the established methods of treatment are effective, without any significant differences in the results. Even so, each method has its own advantages and disadvantages and the costs of treatment are very different. The following table shows the therapeutic options. You should discuss these options with your doctor to find out which type of treatment is the right one for you.

Treatment options for varicose veins according to the guidelines