What does vascular surgery deal with?

According to statistics, 40-50 percent of the population in Hungary suffers from varicose veins, but only 20-30 percent see a doctor and undergo surgery. The ratio is even higher when spider veins and capillaries are included here. In terms of gender, 40 percent of the patients are men and 60 percent are women. The shift in the ratio is mostly due to changes during pregnancy, that is why the balance is tilted in favor of women.

Spider veins, capillary disorders

Description of the disease: Close to the surface of the skin, the existing small capillaries dilate and become visible. These are called spider veins (telangiectasias). Unfortunately, these small bluish vessels do not go away without treatment and may even further expand and become more extensive over time. Initially, this lesion is more of an aesthetic problem (which is why so much more ladies turn to us with this symptom), but as the process progresses, veins can merge and bulge out of the plane of the skin. They can then cause a periodic or ongoing complaint to the patient. Genetics and lifestyle play very important roles in this disease, so we can say that both its appearance and development are strongly dependent on the individual. Among the reasons, we should also mention the possible adverse effects of pregnancy.

Symptoms: The blood vessels become visible under the skin and may protrude from the skin as the condition progresses.

Treatment options: Depending on the condition of the blood vessels, we can suggest several solutions from injection therapy (Sclerotherapy) to radio frequency (RF) surgical treatment.  Both interventions can eliminate this unpleasant lesion very easily, at best for many years.  Details of the surgery can be found here.

Dilation of superficial and deep veins

Description of the disease: Mainly due to the higher blood pressure in the legs, the larger veins and varicose veins expand due to the continuous or intermittent load. In more severe cases, the dilated veins may become inflamed, or if the blood flow slows down so much that thrombosis may develop (e.g., as a result of sitting without movement during a long flight). The severity of the risk of thrombosis cannot be overemphasized: a blood clot released from such a vein can even cause fatal pulmonary embolism, stroke (cerebral embolism), or heart attack.  Therefore, the timely treatment of varicose veins is very important for all of us. Causes: Here, too, mainly hereditary and lifestyle reasons can be listed. In the case of the latter, a lot of standing, sitting work and a large load from sports are also possible. Among the reasons, we should also mention the possible adverse effects of pregnancy.

Symptoms: In less severe cases, heavier feet and skin warmth appear in the affected area, later, in case of superficial vein dilation, ugly blood vessels as thick as a finger bulge out of the skin surface.

Treatment options: Depending on the condition of the blood vessels, we can also offer two different modern surgical solutions: surgical treatment with glue (VenaSeal) or radio frequency (RF).  Details of the surgery can be found here.

Leg ulcers

Description of the disease: Leg ulcers appear in about three-quarters of cases due to varicose veins that have not been treated for a long time: blood flowing to the heart begins to stagnate in the veins due to insufficient function of the venous valves. The blood then may enter the tissues surrounding the stagnant vein, leading to tissue damage and, over time, the development of a leg ulcer.

There are several risk factors that increase the chances of developing venous leg ulcers:

• deep vein thrombosis (when a blood clot forms in the deep veins of the foot)
• overweight
• smoking
• several hours of standing regularly

Symptoms: The first sign of venous leg ulcers is a dark red or purple change in the skin in areas where blood has started to leak from the vein. The skin in these areas begins to itch and may become dry. If no treatment is given at this stage, then leg ulcer develops over time, which is accompanied by swelling and pain in the leg. If the ulcer on the leg becomes infected, the wound may have an unpleasant odor and may become purulent.

Treatment options: Leg ulcer treatment is initially aimed at reducing pain and then at accelerating the healing process. As part of the treatment, patients may also receive antibiotics if they show signs of a bacterial infection. In all cases, it is mandatory to wear an elastic bandage or compression stockings to reduce swelling of the foot and edema.

In most cases, radiofrequency varicose vein surgery can take place after the leg ulcer has healed. In some cases, when the ulcer is already advanced and therefore difficult to heal, surgery can be performed in the presence of the ulcer.

Newly formed and smaller ulcers are much easier to heal than those present for a longer time, so it is advisable to see a doctor as soon as possible if the ulcer has already appeared. Details of the surgery can be found here.

Thrombosis

Description of the disease: In case of dilated veins and the presence of risk factor(s) described above, blood flow may be slowed to such an extent that blood clots can form. These blood clots form mainly in the leg and more specifically in the lower part of it. Thrombosis can be partial – the blood clot does not block the vein – but it can also be complete, in which case the blood flow in the affected vein stops.  The severity of the risk of thrombosis cannot be overemphasized: a blood clot released from such a vein can even cause fatal pulmonary embolism, stroke (cerebral embolism), or heart attack.

In addition to the known risk factors listed for varicose veins, the cause may be a surgical complication or a genetically increased blood coagulation tendency (30-40%).

Symptoms: Partial thrombosis may be asymptomatic, but in more severe cases, symptoms may range from minor leg pain to leg swelling, tension, and pain that intensifies with pressure.

Treatment options: The treatment of superficial and deep vein thrombosis can in most cases be managed with medication. However, in exceptional cases, it may be necessary to treat the veins affected by thrombosis by vascular surgery: these are the cases where the limb is at risk due to severe swelling, that is, the goal is to rescue it. However, it is more common for vascular surgery to take place after the medical treatment for thrombosis, thus eliminating vein varicosity and reducing the chance of thrombosis recurring. Details of the surgery can be found here.

What happens in a personal consultation?

At Emineo Private Hospital, examination begins with reviewing the patient’s and their family’s medical history. In doing so, we ask about, among other things, the medications taken, previous interventions, and similar illnesses in the family.  Depending on the complaint, in addition to a full-body physical examination, we will use a Color Doppler equipment to examine the function of the vascular segment in question, if necessary. In more complicated cases, our specialist may also request vascular staining, CT, or MRI examination, which we will arrange for our patients in one of our partner institutions as soon as possible.

Possible therapies

Whether medical treatment or surgery is recommended, depends on the extent and severity of the complaint. True to a private institution, in all surgeries, we keep in mind to provide the patient with the most appropriate medical solution so that they can return to their normal, normal daily routine as soon as possible. Details of possible surgical treatments can be found here.