Varicose veins and thrombosis: modern treatments in Romania

Varicose veins are abnormally dilated superficial veins, most often in the legs. They appear because the vein valves, which normally stop blood from flowing backward, are damaged. Over time, the veins lose their elasticity and become visible under the skin. Varicose veins can be large and twisted; spider veins are much smaller and usually only a cosmetic issue, although they sometimes occur with an underlying vein problem.
Deep vein thrombosis (DVT) is the formation of a blood clot in a deep vein, most often in the legs. It is a serious condition, because the clot can travel to the lungs and cause a pulmonary embolism. Varicose veins can cause aching, a feeling of heaviness, swelling of the legs and skin changes. DVT usually affects one leg, with throbbing pain in the calf or thigh, swelling, and red or darkened skin around the painful area. It needs urgent medical assessment; if you also feel short of breath or have chest pain, call 112.

Specialists in vascular medicine point out that the risk factors for varicose veins and venous thrombosis include:

• Genetic predisposition
• Standing or sitting for long periods
• Pregnancy and hormonal changes
• Excess weight
• Injuries and previous surgery
• Smoking and a sedentary lifestyle

The symptoms of varicose veins vary: from simple spider veins to painful varicose veins, with inflammation, skin changes and even venous ulcers. In DVT, the symptoms are often sudden: pain, redness and marked swelling of the calf or thigh.

In recent years, vascular surgery in Romania has developed considerably, and patients now have access to minimally invasive methods, with quick recovery and good results. The main options include:

a) Endovenous laser treatment of varicose veins
In this procedure, an optical fiber is inserted into the affected vein under ultrasound guidance. The laser energy closes the diseased vein, and blood flow is redirected to healthy veins.
Advantages: minimally invasive, no large scars, quick recovery

The price of the procedure varies with the clinic and the complexity of the case, but it is often considered worthwhile because of the result and the short recovery time.

b) Endovascular surgery
This technique uses special instruments inserted through small punctures to treat the affected veins without classic incisions. It is used both for complicated varicose veins and for selected cases of DVT.
Advantages: low risk of infection, minimal pain, quick discharge

c) Minimally invasive treatment options for varicose veins

Besides laser treatment, most varicose veins can now be treated with quick, effective procedures, without the need for classic surgery. The most commonly used methods are:

1. Sclerotherapy with foam or liquid

A sclerosing substance is injected directly into the vein. The substance causes a controlled reaction that makes the affected vein close and be absorbed by the body.

Advantages:

• a quick procedure (15-30 minutes),
• no anesthesia needed,
• immediate recovery.

It is well suited to small and medium veins, telangiectasia (“spider veins”) and reticular veins.

2. Radiofrequency ablation (RFA)

It is similar to laser treatment, but it uses radiofrequency energy to heat the vein walls and close the vein. Patients usually tolerate it well.

Advantages:

• little pain,
• a high success rate,
• a short recovery time.

3. Microphlebectomy

It is done through very small incisions (2-3 mm), through which segments of the affected vein are removed. The scars are usually small and fade over time.

Advantages:

• it removes the visible veins,
• long-lasting results,
• no hospital stay needed.

4. How we choose the right treatment method

There is no single solution for every case. The choice of method depends on:

• the size and location of the varicose veins,
• how severe the venous insufficiency is,
• your general health,
• your preferences and your doctor’s recommendation.

The specialist usually performs a venous Doppler ultrasound to assess blood flow and plan the right treatment.

5. Recovery after minimally invasive treatment

One of the main advantages of these methods is that you can quickly return to your usual activities.

General recommendations after the procedure include:

• wearing compression stockings for a few days or weeks,
• avoiding intense physical effort in the first days,
• daily walks to stimulate circulation,
• attending your follow-up visits.

The results become visible gradually, as the treated veins are absorbed and circulation improves.

Left untreated, varicose veins and deep vein thrombosis can lead to serious complications: ulcers, permanent skin discoloration, chronic venous insufficiency and pulmonary embolism. An early consultation with a specialist in vascular medicine or vascular surgery is essential to decide on the right treatment.
Recommended steps:

1. Book a venous Doppler ultrasound to assess your circulation; if you have signs of DVT, get urgent medical help the same day.
2. Agree on a personalized plan. For varicose veins, this may include laser treatment, endovascular surgery or other minimally invasive methods. DVT is treated mainly with blood-thinning (anticoagulant) medicines, usually for at least 3 months; endovascular procedures are used only in selected cases.
3. Follow-up after treatment, to prevent recurrence or catch it early.

Today, thanks to advances in vein surgery, endovascular surgery and blood-thinning medicines, patients in Romania have access to modern treatments for varicose veins and deep vein thrombosis.

Whether we are talking about varicose veins in one or both legs or about spider veins, there are treatments that can give good results (endovenous laser treatment for larger varicose veins, sclerotherapy for spider veins), with a positive effect on both health and appearance.
An active lifestyle, weight control and avoiding long periods without moving can help prevent vein problems from coming back. And if you already have symptoms, do not put off seeing a specialist: in vascular medicine, timing matters.

If you are in Constanța, NOVOMED CLINIC offers vascular surgery consultations, Doppler ultrasound and sclerotherapy; for laser, radiofrequency or surgical treatment, we refer you to a center that performs them. See varicose vein treatment, options and prices and sclerotherapy.

Frequently asked questions about varicose vein treatments

1. Are varicose vein treatments painful?
Usually only mildly. Most minimally invasive procedures are well tolerated and need only local anesthesia, or none at all. You may have some pain or bruising afterward.

2. Can varicose veins come back after treatment?
After laser or radiofrequency treatment, the treated vein usually stays closed; after foam sclerotherapy of the large superficial (saphenous) veins, it reopens more often. New varicose veins can also appear in other areas, which is why regular check-ups are recommended.

3. How long until I can return to my normal activities?
In most cases, patients return to their activities within 24-48 hours.

4. Are the treatments only cosmetic, or medical too?
They can improve both how your legs look and the symptoms caused by venous insufficiency.

Medical sources

• NHS: Deep vein thrombosis (DVT)
• NHS: Varicose veins
• Gloviczki P et al. The 2022 SVS, AVF and AVLS clinical practice guidelines for the management of varicose veins of the lower extremities, Part I. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2023;11(2):231-261
• Gloviczki P et al. The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2024;12(1):101670
• NICE: Varicose veins, diagnosis and management (clinical guideline CG168)