Gymnastics for venous insufficiency

Venous insufficiency of the lower limbs can take various forms, such as varicose veins, spider veins and flevektasies while more advanced manifested by edema (swollen feet), ulcers or venous stasis dermatitis. Venous insufficiency is a disease that continues to worsen and occurs with increasing frequency in recent years. The regression and stagnation of blood within the peripheral veins except edema, and causes a series of asthma symptoms such as fatigue and heaviness, burning and pain with particular deterioration summer.

An important mechanism of our body that helps venous circulation of the lower limbs is muscle "pump" which is essentially confined mainly gastrocnemius (calf). Their contraction during walking or exercise, substantially helps the veins to send the blood upwards thereby enhancing the physiological functioning.

Exercises and tips for venous insufficiency

 Avoid prolonged standing and sitting position and use special elastic stockings.

 If you have a desk job to avoid cross your legs, get up regularly for walking and use a footrest.

 Under the desk:

1. • regularly run rotary movements of the limbs and feet and frequent bending and extent
2. • slowly stretch your knees and keep it stretched for at least 5 seconds
3. • the heels glued to the floor anevokatevaste the toes tapping rhythmically floor
4. • the toes glued to the floor anevokatevaste the heels lygizontas knees slightly

 In forced upright anevokatevaste slowly throughout your body one on the toes and heels on one foot (staying for a few seconds on each move and with many repetitions during standing). After some time, you can repeat the same exercise by relying only on one leg.

 Rest your feet in high anarropi place 3-4 times a day for 15-30 minutes and throughout the night (above 1-2 pillows).

 During the day do regular cold baths (with shower phone from the bottom up as a Jacuzzi) and certainly in the evening before bedtime.

 Any physical activity such as daily walking, light jogging, cycling and especially swimming in hours without sunlight and ample moisture helps the venous circulation.

 Physical exercise helps maintain ideal body weight and the necessary weight loss for overweight people with venous insufficiency.

 In large venous insufficiency excessive or intense athletic activity but can aggravate the problem.

 In the gym exercises greatly increase intra-abdominal pressure can worsen venous insufficiency. The rule for these exercises is to become your feet up rather severely. Exercises that are recommended are:

1. • abdominal feet up
2. • exercises "bench" with a few weights, walk in horizontal position or anarropi
3. • aerobic gymnastics "scissors" or "circles" with foot
4. • horizontal bike
5. • leg exercises you train the gastrocnemius

Individuals with a large venous insufficiency should consult a vascular surgeon and trainer to create personalized exercise program, should they wish to exercise in the gym.

Sclerotherapy and microthermocoagulation - Α perfect treatment combination for spider veins

Spider veins are dilated venous capillaries that appear as small red, purple or blue veins under the skin, usually in women and even in proportion reaches 50% of the female population. Some predisposing factors are heredity, weight gain, sedentary life, standing and hormonal changes.

Spider veins occur as isolated venous capillaries or as large varicose formations (spider veins). The spider veins are so named because they have the shape of a spider web, consisting of very small veins usually start from one or two central veins and veins lead to thinner radially at the periphery. Usually only create aesthetic problem, but rarely cause mild symptoms (numbness, burning, weight).

The sclerotherapy is the oldest and highly effective treatment of spider veins and especially those with large and medium diameter. Involves injecting sclerosing substance in veins greater than a millimeter, using very thin needle. The sclerosing substance is either a foam or as a solution causes fibrosis of the wall of the spider veins and occlusion. In this way the blood can not enter again into the small vessel, and it is no longer visible. Improved technique of sclerotherapy offers a relatively short time, immediate results (2-8 sessions depending on the extent of the problem) with minimal risk of complications and almost painless way. The drawback of this method is that it requires the application of elastic bandages or stockings immediately after treatment and prophylaxis of the sun about it and applied all seasons except summer.

This method finds application now also using sclerosing foam to bigger problems like reticular veins  or recurrent varicose veins after surgical repair, when applied under ultrasound guidance at practice. With the use of local anesthetic in the form of cream or spray, the treatment is virtually painless and acceptable for all women, even the most sensitive.

The sclerotherapy may conveniently be combined with a new method for the microthermocoagulation disappearance of fine varicose veins even those who rarely remain after treatment with sclerosing injections.

The microthermocoagulation with the TC3000 system is an innovative method that dramatically changes the field of fine spider veins treatment. Solves in treating varicose veins for each region of the body in all skin types, all year round, without the risk of side effects and safely. The virtually painless application has spectacular results in the treatment of spider veins with very small diameter (0.1 to 0.9 mm), capillaries (telangiectatic matting), red spots (red dots - red spots - cherry hemangiomas) and rosacea (telangiectasias face - nose).

The system TC3000 generates high frequency waves (4 million Hertz) and through a very small needle (diameter from 0.075 to 0.15 mm) yields pulsed manner which causes thermal energy focused thermocoagulation interrupting blood flow through the vessels. In this way, "off" the spider without any risk or damage to the skin. Immediately after treatment spider veins disappear immediately, while the next few minutes begin to appear red papules. The effect is evident after 48 hours, but the traces of treatment (tiny scabs) remain visible for a few days to 3-4 weeks (depending on the skin type) before their definitive extinction.        

After long-term clinical experience in Europe with impressive results, the system TC3000 and the  U.S. Veinwave, approved by the FDA as a novel method for effective treatment of varicose veins, red spots (red dots-red spots) and rosacea (spider veins face-nose).

The method of thermocoagulation offers at short period immediate results. It does not require elastic bandaging and prophylaxis of the sun after the treatment for it and applied all year round.

The combination of sclerotherapy and microthermocoagulation is an ideal technique of treating spider veins of all types with a success rate greater than 90%.

Vascular Surgeon

Georgios Vourliotakis MD, PhD

 

Endovascular fellowship  in University Medical Center of Groningen, Netherlands

Tel: 2177008002, Mob: 6937332302, www.aggeia.gr

Vasilissis Sofias Avenue 122, Athens, 1st Floor, 1st Office

 e-mail: gvourliotakis@aggeia.gr

Endovenous laser ablation of varicose veins

 Chronic venous disorders of lower limbs are problems caused by venous hypertension. It is created as a result of chronic valvular insufficiency of the saphenous veins and their branches. In patients with  saphenous vein insufficiency and depending on the clinical stage of vein disease, treatment should begin with the elimination of this deficiency.Until recently the best way to achieve this was the saphenous vein ligation before its junction in the deep venous system and the  excision of the saphenous vein and its branches (vein stripping). The last 10 years this method was gradually replaced by other minimally invasive, intravenous treatment methods using Laser or RFA (Radio Frequency Ablation), without the need of removal of the affected saphenous vein.

Picture 1. Combination Laser and micro venotomies      Picture 2. Ultrasound vein mapping before treatment

The endovenous Laser ablation is a bloodless surgery treatment which could be performed under local anesthesia and ultrasound guidance, with safety and accuracy, while its implementation requires very precise planning and mapping of the affected vein before surgery.From the area of ​​the tibia the optical fiber Laser is inserted trans dermal in the saphenous vein and advanced proximally, promoted head as the amount of contribution safinomiriaias. The saphenous vein is filtered around the cold solution with special local anesthetic. Depending on the diameter and length of the saphenous to be treated is calculated the amount of energy to be given during the treatment. As the fiber optic is withdrawn progressively diffuses radially energy which shrinks uniformly venous walls and seals completely vein. After closing the treated vein circulation restored through healthy veins network.

Picture 3. Ultrasound imaging of saphenofemoral junction during the Laser ablation 
Picture 4. Immediately after treatment, confirmation of vein occlusion

The total process lasts 20-30 minutes, is almost painless during and after the treatment, with no cuts or stitches, while the results are immediate. The risk of discoloration, burning, bruising or other complications is minimal especially with the new generation of optical fiber. The advantage of this method is the possibility of applying in the early stages of venous insufficiency and the simultaneous combination with other methods such as foam sclerotherapy  and micro venotomies of peripheral varicose veins.The patient in consultation with a physician can go home even the same day fully mobilized and in his previous activities in 2-3 days except exhaustive exercise.