Varicose vein surgery

Synonym(s)

Operative procedures in phlebology; Varicose vein operations; Vein operations

Definition
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Varicose veins are one of the most common clinical pictures in the Central European population. About 70% of the German population show pathological changes of the peripheral venous system, with women being affected significantly more often than men. A total of approx. 12 million patients are affected by varicosis, whereby approx. 20% suffer from trunk varicosis, 50% from branch varicosis, 2/3 from reticular and 1/3 from spider veins. In total, 5% of the cases are in need of treatment. Aim of the surgical procedures (as well as of the sclerosing procedures - see below sclerosing, foam sclerosing) is the interruption of reflux at the proximal and distal point of insufficiency and the removal of diseased insufficient vein parts of the epifascial venous system.

General definition
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Classical varicose vein surgery:

Surgical removal of the crusts of the vena saphena magna (magna-crossectomy).
Perforating and side-branch varicose vein surgery (direct epi- or subfascial ligature or, in advanced CVI, also a subfascial endoscopic ligature (SEPS = subfascial endoscopic perforating vein surgery). The lateral ataxectomy is performed through the smallest possible skin incisions at a distance of 3-5cm. The lateral branch veins are "fished" with fine hooks and then removed with small clamps.

Endoluminal thermal therapies: Can be used to treat insufficient truncal veins as well as lateral branch and perforating varicose veins. In these procedures, the insufficient vein at the distal point of insufficiency is first punctured or exposed under ultrasound control. Depending on the technique used, different catheters are then positioned via an airlock and the therapy is initiated. The following procedures are currently valid and can be used depending on the experience of the therapist: