Introduction
In medical terminology, varicose vein disease is called varicosis. It is a dilatation and bulging of superficial veins, which leads to a tortuosity and tangling of the affected vein. This usually affects the veins of the legs.
Eventually, the superficial veins are no longer able to efficiently transport the blood back to the heart. This is usually due to the fact that the venous valves no longer function properly. Not only can varicose veins be a cosmetic problem, they can also lead to heavy legs and evening leg edema, i.e. water retention. Heredity plays a very important role in the appearance of varicose veins, but varicose veins also occur more frequently during pregnancy.
When must varicose veins be removed?
Varicose veins are often a cosmetic problem. If the level of suffering is high enough for those affected, the affected veins can be removed by surgery. Surgical removal may also be indicated for symptomatic varicose veins, e.g. due to oedema (water retention).
Furthermore, varicose veins can also lead to complications. One complication is the recurring occurrence of inflammation in the veins or the formation of thrombi, i.e. small blood clots that obstruct the vein. In such a case surgery is recommended.
However, there are cases in which the veins must not be surgically removed. In about 5% of cases, varicose veins are caused by secondary varicosis. In this case, the first symptom is an obstruction of the outflow in the deep vein system.
For this reason, the blood must increasingly be transported from the legs back to the body via the superficial leg veins. This can then lead to the formation of varicose veins. The superficial veins now represent the main part of the blood return transport and must therefore not be removed.
Preparation
As before any operation, the first thing to be done is a doctor-patient consultation and a physical examination by the doctor. Then the veins are visualized and examined with the help of ultrasound. In some cases, a so-called phlebography may also be performed.
In this case, the veins are depicted with the help of a contrast medium and an imaging procedure, e.g. MRI. These preliminary examinations are important in order to exclude other diseases or to detect concomitant diseases. In addition, the extent of the varicose veins is examined and it is planned which veins are to be removed. Directly before the operation, the corresponding veins are marked on the patient still standing. In addition, blood-thinning medications such as Marcumar should be discontinued by the treating physician beforehand.
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