Thrombosis, bleeding, skin lesions, heaviness, fatigue, pain and itching are some of them, while in general superficial venous insufficiency is found in almost 30% of the general population.

The most frequently asked questions about varicose veins of the lower extremities are answered by Mr. Sofokles Trachanellis Vascular surgeon at Metropolitan Hospital:

1. Is it just an aesthetic problem?

Although one of the common reasons someone decides to treat varicose veins is cosmetic, varicose veins are also a medical problem due to their potential complications. More important complications are thrombosis, bleeding and skin lesions, such as lipodermasclerosis and chronic ulcers. These complications are rarely life-threatening, but are very important for quality of life. Varicose veins can also cause symptoms, such as a feeling of heaviness, fatigue, pain, itching, irreversible pigmentation (tanning) of the skin and others.

2. How are they treated?

The definitive treatment of varicose veins is purely invasive. None of the non-invasive means can cause a remission of the disease, nor can it eliminate the unsightly veins.

3. What do we mean when we say intravascular LASER or RF?

They are the newest techniques which are less invasive and patient friendly. They offer painless treatment, a shorter post-operative recovery period, are performed without incisions and sutures and have just as good a result as classical methods. Also a newer alternative method I use is the convergence of the saphenous vein with cyanoacrylate glue. It is safe, less invasive and in certain cases does not even require the administration of anesthesia or the use of stockings post-operatively.

4. How painful is their treatment?

With the use of new techniques, it is a painless operation, with no particular post-operative discomfort. The hospital stay is only for a few hours and most patients do not even feel the need to use painkillers.

5. Are vein procedures safe?

These are operations that are usually performed daily and serious complications are rare and easily treatable.

6. Are the ankle swellings and pains I have due to varicose veins?

These symptoms can have multiple causes, but very often they are due to varicose veins. Although it is difficult to estimate with certainty whether the operation will cause a permanent remission of these symptoms, in the majority of cases the quality of life after the operation is significantly improved.

7. Does the operation have a permanent effect?

Venous insufficiency of the lower extremities is a chronic degenerative disease. There are multiple venous systems in the lower extremities. When a vein operation is performed, only the veins that are affected at that particular moment are treated. It is difficult to predict whether other veins will develop in the future. After all, this depends on many factors, such as lifestyle, weight, hormonal factors, pregnancies, etc. The affected venous system does not recur, but other venous systems are likely to degenerate in the future. For this reason, some patients may develop new veins in the future. Reoperations are usually simpler and more patient-friendly, and in some cases new varicose veins can be treated with simpler methods, such as sclerotherapy.

8. What are the advantages of newer techniques compared to the classic surgery?

They are more patient-friendly, less traumatic and have a shorter recovery period. They are done without incisions, usually do not need to be sutured, do not cause large hematomas and are more painless. The chance of nerve injury is also reduced. However, there are some advanced cases of venous insufficiency in which they are not indicated, so classic surgical intervention still has a place nowadays.

9. Do private insurances cover the costs of surgery in a private clinic?

Varicose veins are a medical disease and private insurances cover their treatment. On the other hand, aesthetic interventions, such as sclerotherapy of retinal vessels, are usually not covered. The percentage of coverage depends on the contract in question. Usually individual policies cover all expenses, including medical fees. Some other policies cover a large percentage of the costs. Before performing the operation, pre-approval is usually requested from the insurance company.

10. How long does recovery take after surgery?

Depending on the severity of the problem and the technique that will be performed, the recovery usually lasts from 5 to 15 days. Returning to work also depends on the type of work. In general it is good to avoid standing and lifting weights for the first few days. The patient is ambulatory from the first moment, but rest is ideally recommended for the first few days. Also after the operation it is recommended to use a graded compression sock for 10-15 days. The corresponding sick leave is also granted and justified.

11. Is it a common condition?

It is quite a common condition. In general, superficial venous insufficiency occurs in almost 30% of people and is more common in women.

12. Is it hereditary?

There is clearly a hereditary predisposition, but the appearance of the disease also depends on lifestyle. Factors blamed for faster progression of the problem include standing, heat, a sedentary lifestyle, weight gain, pregnancy and contraceptive use.

13. When is the right time to treat varicose veins?

There are no restrictions, it is an operation that can be performed at any time of the year. On the contrary, sclerotherapy of the vessels should be avoided in the summer months. When the operation will take place has mainly to do with when the interested party may be absent from work for a few days. Exceptions are other conditions, such as thrombophlebitis, where the need for treatment becomes more urgent.

14. Is anesthesia necessary?

Thermal ablation methods such as LASER and RF generate heat. Some kind of anesthesia is necessary for the patient’s comfort. For this reason, these operations are always performed in the presence of an anesthesiologist. Always depending on the severity of the disease and the type of technique to be used, some kind of light general anesthesia, intoxication or spinal anesthesia can be done. In rare cases where only a vein stem is affected and varicose veins have not yet formed, the operation can only be performed with local anesthesia and the use of cyanoacrylate glue.

15. Does surgery make sense in advanced cases where there are skin complications?

Some complications of advanced varicose veins such as pigmentation are irreversible or only slightly reduced after surgery. But in these cases the operation is deemed necessary to avoid further damage to the skin. Also, surgery is necessary to treat conditions such as recurrent venous ulcers.

16. What is thrombosis?

The presence of varicose veins increases the possibility of thrombosis. Thrombosis is the solidification of blood within the veins. It is a potentially dangerous situation because the migration of the clot into the pulmonary arteries (pulmonary embolism) is in some cases life-threatening.

17. How long should I wear the stocking after surgery?

It is usually recommended to wear a stocking for 10-15 days after surgery. More generally, however, the use of socks before and after surgery has beneficial effects on the progression of the problem.

18. How long should I be absent from work? Is sick leave justified?

Usually the absence from work, depending on the severity of the problem and the nature of the work, lasts from 5 to 15 days. In consultation with the patient, the corresponding sick leave is granted