What is the causal treatment of venous disease?

As the long-standing practice of the team at the Department of Phlebology shows, most errors in the treatment of venous disease result from inadequate diagnosis. The consequence of this is an incorrectly selected treatment regimen.

As many years of practice have shown the team of the Department of Phlebology most errors in the treatment of venous disease (the most common form is venous insufficiency of the lower limbs and pelvic venous insufficiency) results from an inadequate initial diagnosis, most often at the stage of performing a Doppler ultrasound examination of the venous system. The consequence of this is an incorrectly selected treatment regimen.

For this reason, in the Department of Phlebology initial diagnostics is based, if necessary, on the full scheme Doppler ultrasound of the veinswhich includes assessment of the veins of the lower limbs, small pelvis and abdominal cavity.

After the first phlebology visit, which always consists of an initial ultrasound assessment, the patient is often referred for what is known as a 'phlebectomy'. extended diagnostics, comprising:

• computed tomography venography (CTV)
• magnetic resonance venography (MRV)
• digital phlebography
• intravascular ultrasound (IVUS)

This approach allows us to effectively detect causes, or complex anatomical phenomena predisposing to venous insufficiency. The diagnostic and therapeutic regimen we have been using for years proves that this approach guarantees much more effective treatment than the one used previously. This is particularly evident in patients whose venous disease occurred at a young age, especially in women before their first pregnancy. Here, the percentage of incorrect therapeutic decisions is by far the highest.

The classical approach, which in a nutshell consists of surgical removal or closure (e.g. with sclerotherapy or glue) of varicose veins or major venous trunks on the legs, is a treatment characterised by a high rate of recurrence and, in the long term, deterioration of the venous system (its significant overload). Patients who have undergone incidental sclerotherapy of spider veins or surgical removal of veins in the past usually come to us for re-treatment.

In the Department of Phlebology causal treatment of venous disease, is based on a complete haemodynamic ('hydraulic') and anatomical analysis of the patient's venous system. It usually starts with the treatment of the underlying problem in the setting of the Vascular Laboratorywhere the following are performed minimally invasive intravenous proceduresboth under ultrasound guidance (percutaneous and intravascular ultrasound) and assisted by X-ray equipment using state-of-the-art Philips C-arm.