When venous diseases remain undetected

re varicose veins actually only an aesthetic problem?

Dr Salama: Varicose veins, which mainly appear on the legs, are clearly visible veins that run mainly under the skin, are pathologically dilated and are either tortuous or have nodular bulges. Since more than 30 % of adults are affected, varicose veins can be described as a common widespread disease. It is not only the cosmetic impairment and the feeling of heavy legs that make treatment of varicose veins so important: As the disease progresses, there is a risk of spreading to the deep vein systems with chronic venous insufficiency (CVI).

What are the prerequisites for effective treatment?

Dr Salama: The human venous system is in many ways more complex than the arterial system. A comprehensive understanding of venous anatomy as well as pathological processes and dysfunctions in the human organism and their origin, but also the available diagnostic tests are essential for the treatment of venous diseases. An effective venous return from the lower extremities requires the functioning interaction of the heart, air pressure gradients, peripheral muscle pumps of the legs and competent venous valves. Severe forms of chronic venous insufficiency are the result of venous hypertension or the inability to lower venous pressure during physical exertion.

What are the benefits of duplex sonografies and colour-coded duplex sonografies? 

Dr Salama: Duplex sonografie is an ultrasound procedure that not only allows soft tissue structures to be visualised, but also, by means of colour coding, the flow velocity and flow direction of the blood can be identified. Duplex sonography is considered particularly helpful for detecting and localising chronic venous obstruction, i.e. when an outflow obstruction causes a venous, pathological increase in blood pressure in the affected leg. This examination method is also useful in cases of reflux or possible valve insufficiency. However, duplex sonography provides little quantitative information on the flow mechanics of the blood.

What is the role of haemodynamics in venous disorders?

Dr. Salama: The haemodynamic function of the function of the veins is the targeted drainage of blood. Causes of drainage insufficiency include ineffectiveness of the circulation, rapid expansion of the calves, poor responsiveness of the vein walls to gravity and positional causes such as prolonged standing or sitting. Venous diseases are haemodynamic diseases and therefore treatment must take haemodynamics into account.

What are important parameters in vein diagnostics and treatment? 

Dr. Salama: In the LBCL, we use the following parameters Surgery & Vein Practice has long relied on important parameters that are valuable in follow-up care and in assessing the success of treatment. They accompany us in the follow-up on the 14th day and on the 28th day after the treatment of varicose veins. The objectivity of crucial parameters is of great importance for every patient with venous disease. Treatment without collecting these values at initial diagnosis or follow-up makes no sense at all!

Successful treatment is evident not only in the disappearance of the unwanted diseased veins when illuminated, but also in the improved appearance of the skin and the restoration of the (feminine) lines of the leg. Patients report that their legs feel lighter and that they enjoy moving and walking more. They also feel more energetic and healthier, while the stagnated blood in diseased veins starts to follow the circulation again.

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