Understanding and treating leg varicose veins

Leg varicose veins, a health problem that affects 20 million French people. What is a varicose vein? What is the support? Details from Martin Ducret.

Martin Ducret, doctor and journalist at Doctor’s Daily, speaks to us today about varicose veins of the legs, a health problem which affects 20 million French people, and he particularly discusses their treatment.

franceinfo: First of all, what is a leg varicose vein?

Martin Ducret: A varicose vein is the abnormal dilation of a superficial vein in the lower limbs, which then becomes visible under the skin. This is the consequence of venous insufficiency, that is to say that the veins no longer do their job of bringing blood back to the heart, so the blood stagnates and the veins dilate.

Varicose veins can be accompanied or preceded by other symptoms, such as a feeling of heavy legs, pain, itching or even edema.

What to do in case of varicose veins?

In all cases, it is necessary to promote good venous return by practicing regular physical activity, such as walking for example, avoiding exposure of the legs to heat, and losing weight in the event of excess.

Concerning medications, venotonics such as Daflon can reduce symptoms, and wearing compression stockings or socks helps improve venous return. When varicose veins persist despite everything, whether they are aesthetically annoying or cause disabling symptoms, the treatment is then more invasive.

To understand better, imagine a tree. To treat collateral varicose veins (the branches of the tree), there is sclerosis, carried out in the medical office, which corresponds to the injection of a liquid product or foam into the veins.

Then there is laser or radiofrequency, the aim of which is to block the main vein, the saphenous vein which corresponds to the trunk of the tree. More radically, we can use striping, a surgical procedure to remove the saphenous vein.

But is there a less popular, and much less aggressive, treatment than the methods you just mentioned?

Yes, it is a surgical technique, validated by numerous studies, the ASVAL method (selective ablation of varicose veins under local anesthesia) which was designed by Dr Paul Pittaluga, vascular surgeon in Paris. “The principle, my colleague explained to meis to remove, using very small incisions, only the collateral veins (the branches of the tree) responsible for the varicose veins.”

The advantage of this ambulatory technique, which does not use any product, is to avoid recurrences, by preserving the venous capital, thanks to the preservation of the saphenous vein (the trunk). In addition, no need for dressings and rarely any time off work.

Unfortunately, this method is not yet reimbursed by social security, and too few practitioners still use it, due to a lack of mastery of this specific surgical technique.