Treatment for this problem includes home remedies, herbal methods and some non surgical techniques such as laser ablation, sclerotherapy injections. But these methods are effective only in case of small varicose veins. While in case of large and severe varicose veins and when all the other treatments fail, the surgery is recommended. Surgery is the last hope for the treatment of varicose veins as there are certain conditions in which surgery becomes inevitable.
It is known that the incompetency of venous valves leads to varicose veins. The leaflets of valves do not meet properly so the chances for the pooling of blood in the leg veins get higher. Movement of blood through the veins becomes slower leading to the stasis of blood. This stasis of blood in vein stimulates the formation of clots or thrombus which is termed as thrombophlebitis. It is a life threatening condition because thrombus can dislodge and move in the blood vessels. The thrombus may get impacted in vessels supplying to other areas of the body especially vital organs such as brain, heart, lungs etc. This can lead to sudden and complete blackening of vessels leading to ischemia and necrosis of the tissue. So in case of thrombophlebitis the surgery must be done to save one’s life.
Untreated varicose veins lead to many other severe complications. One of them is the formation of venous ulcers. Patient is recommended for surgery if there are signs of ulceration. Varicose veins do not allow the blood to move back to the heart so the high back pressure develops in the veins especially the veins of legs. This high blood pressure in veins damages the thin endothelial walls of the vein which then elicits the inflammatory response by recruiting white blood cells to the site of injury. Due to the increase vascular permeability and high venous pressure, the proteins and other cells of blood leak through the endothelial cells into the extra vascular compartment. This in turn activates the immune system of the body and the process of inflammation starts rapidly. Inflammatory responses do not remain confined to the veins but also promote the necrosis of surrounding subcutaneous tissue. Area around ulcerated vein becomes reddish, swollen, and tender which is known as lipodermatosclerosis. Patients with varicose veins and chronic venous congestion are prone to develop this disease. So if the patients suffering from varicose veins, presents with ulceration it becomes necessary to treat them surgically.
Small varicose veins do not cause much harm and they can be treated by a number of non-surgical methods. Clinical indications for surgery in small varicose veins is aching and burning pain in the region of varicose veins. When symptoms cannot be relieved by any other method then surgery is the last option.
Another clinical indication is bleeding because in certain cases the varicose veins expand too much that they start rupturing. So in all these condition surgical methods has to be applied for the safety of patient.