Phlebology

Varicose veins (varices) are abnormally dilated superficial veins. Varicose veins are often caused by malfunctioning valves in the leg veins.

Diagnosis

The diagnostic procedure of choice is colour-coded duplex sonography (FKDS). This allows the superficial and deep leg veins to be accurately visualised and possible causes of varicose veins to be identified.

Treatment

Once a diagnosis has been made, we offer you the best treatment for your individual needs, from conservative measures to surgery.

If surgery is necessary, we use a variety of procedures:

• Conventional open surgical procedures, such as crossectomy and "stripping", i.e. the removal of the diseased trunk vein
• Endoluminal occlusion procedures such as radiofrequency ablation (RFA) or laser therapy: In RFA, the vein to be treated is punctured with a cannula under ultrasound guidance and a catheter is inserted into the vein using a guide. Once the catheter is activated, a predetermined amount of energy is applied and the vein is thermally sealed. Blood is drained away through the healthy segments of the vein.

In selected cases of acute deep vein thrombosis, an interventional venous thrombectomy is performed, i.e. the blood clot is removed by puncture and catheter, and then a stent is often inserted into the constricted area of the pelvic vein. In most cases, however, acute interventional therapy is not necessary. Drug therapy, i.e. taking blood thinners (anticoagulation), and consistent compression therapy are essential.

Feeling of heaviness

The consequences of venous diseases include a feeling of heaviness in the legs and a tendency to swell (chronic venous insufficiency).

Post-thrombotic syndrome

After a deep vein thrombosis (DVT), a condition known as post-thrombotic syndrome can develop, with symptoms such as claudication venosa, i.e. pain on exertion and a feeling of pressure/tightness in the legs as a result of increased pressure in the venous system. Over time, this can lead to chronic skin changes and even leg ulcers.

Leg ulcers/ulcus cruris

These can develop over many years with chronic venous disease. In addition to venous diseases, many other conditions, such as vasculitis or pyoderma gangraenosum, can cause leg ulcers. A careful differential diagnosis in collaboration with the dermatology clinic and polyclinic, including biopsy if necessary, is therefore important.

Treatment

Conservative treatment always includes consistent compression therapy after exclusion of relevant arterial disease. In addition to treatment of varicose veins and reopening / recanalisation of chronically occluded deep veins, including stent implantation using intravascular ultrasound and intraoperative contrast imaging (phlebography), local procedures such as ulcer caving, fasciotomy, fasciectomy, wound conditioning with negative pressure therapy and split-skin grafting are used for chronic venous ulcers.