Reflux in the saphenous vein, what now?
Saphenous vein with reflux is not necessarily a sick saphenous vein!
You had a duplex and several vessels appeared painted red, and it mentions saphenous reflux in the text. Don't despair. The first thing to know is that you have time to choose the best treatment. Urgent varicose vein surgery is rare (if it exists). You can calmly choose the best procedure or even choose to wear elastic stockings your entire life. Let's summarize the biggest mistakes when declaring a saphenous vein as sick just because of the reflux that appeared.
Error Number 1: We have observed some recurring mistakes in Doppler ultrasound assessments. For some reason, the exam often classifies the saphenous vein as having reflux based solely on the color Doppler visualization. After all, the exam is called color Doppler ultrasound, right?
INCORRECT: If the reflux wave analysis of the saphenous vein is not performed, it is impossible to confirm the presence of reflux. (See the wave analysis below.) Diagnosing reflux based only on color Doppler can be inaccurate, as it does not measure time or volume. Unfortunately, we have seen numerous cases where the spectral analysis was not used, and reflux was diagnosed solely based on color Doppler in the saphenous vein.
Color does not allow us to know the duration or volume of reflux - it cannot diagnose reflux on its own.
The spectral wave shows us the reflux and quantifies its volume and the time it lasts.
Error Number 2: Let's say there is a wave of reflux on the exam, then yes, the saphenous vein is diseased. Correct?
INCORRECT: There are numerous studies that show that reflux is reversible in some cases. Procedures can resolve reflux (we see this every week). Weight loss and suspension of vasodilators can also reverse this. Even without resolving the reflux, we can improve circulation and reduce pressure, stopping signs and symptoms without having to destroy the saphenous vein.
Error Number 3: Let's say I have reflux and symptoms. I don't want to wear elastic stockings. Do I need to destroy my saphenous vein? Burn it with laser or radiofrequency? Take it out in common surgery? Close it by inflaming it with foam?
Not necessarily. There are sclerotherapy procedures that can restore the saphenous vein in some initial cases. Even in the most serious cases, we can perform surgeries based on circulation (hemodynamics) and solve flow problems while maintaining the saphenous vein. Take away the reflux source, and the vein t can reduce in size, reflux and symptoms improve.
We do this routinely around here. Let's talk about the 3 reasons.
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If the person needs a saphenous bypass in the future, the saphenous vein is there.
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Removing the saphenous vein eliminates the main blood flow in the event of trauma or deep thrombosis in that leg, in case it happens in the furute.
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The body deals with the destruction of the saphenous vein in several ways. The body will need to resolve the lack of a vein, and the solution is not always what we want, as it can stimulate new vessels.
Yes, we can preserve the saphenous vein with reflux without rest on local anesthesia.
Discover the techniques that preserve the saphenous vein by improving circulation without destroying all the vessels involved.
The CHIVA technique is a technique brought from Europe that is bringing many possibilities for the treatment of varicose veins in Brazil. We use hemodynamic assessment to define the points that are creating increased pressure in the veins. So, we resolve these points and keep as many veins as possible. Always preserving the saphenous veins, even if they have reflux.
Dr. Felipe Faccini, one of the pioneers of this technique in the country, has already been invited to speak about it at several congresses, due to its success and effectiveness. Congresses in different states of the country, Argentina, Uruguay, Spain, Italy, China.
How does it work?
The CHIVA technique uses hemodynamic mapping performed on the leg using a Doppler ultrasound device. This means that, instead of destroying all the vessels in the leg, the treatment is directed only at the veins that cause blood to "leak" to the wrong place. Preserves the saphenous vein and improves circulation by resolving the change in flow that causes increased pressure and the growth of varicose veins.
Think of the veins in your legs like water pipes in a house. Over time, some of these pipes can wear out, causing problems. CHIVA and other preservation techniques are like having a specialized plumber who uses modern tools to repair only the pipes that need it, without having to destroy the entire pipe.
In other words, depending on the person's case, we adjust the procedure that best suits them. Depending on the circulation situation (hemodynamic) Dr. Felipe Faccini defines the treatment. The procedures are performed using local anesthesia and do not require rest.
Maintains the
Saphena
Improves the
Circulation
Augmented Reality
+ ECODOPPLER
• Uses hemodynamics to improve flow
• Maintains the saphenous vein to save life if necessary
• Precise and minimally invasive treatment based on venous hemodynamics
• Quick and effective procedure
• Fast recovery
• Employs vein viewing equipment and EcoDoppler to see veins that do not appear to the naked eye
• Minimizes the need for surgery
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Improves blood circulation and leg health: Sometimes it can even reverse saphenous vein reflux. When it does not reverse, the reflux is greatly reduced and directed towards a perforator that takes it to the heart. This solves the circulation problem and maintains the vein.
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Aesthetic improvement: Reduces varicose veins effectively and safely. But it keeps blood circulating in them in small quantities. Without swelling them like before.
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Preserves the saphenous vein and the maximum amount of its venous capital: All the techniques we use preserve the great saphenous vein.