Varicose veins: causes, symptoms, treatments and prevention

KEIT Day Hospital has 3 operating theatres, 2 inpatient wards with 10 rooms and 20 beds, an in-house laboratory, and a postoperative resuscitation room, allowing surgical procedures and postoperative care to be managed within the same facility.
The operating theatres are equipped with ventilation systems featuring HEPA filters, laminar airflow above the operating table, and positive air pressure. These technologies help control air quality and reduce the risk of contamination in the surgical environment. The facilities also include electric operating tables, Surgiris LED surgical lighting systems, Karl Storz surgical instruments, and modern equipment for monitoring patients' vital signs.
The inpatient rooms are also designed to support patient safety and care during recovery. In addition to centralised oxygen and medical suction systems, they feature three alarm systems: a bedside device, a portable wrist-worn device, and smart sensors integrated into the bed and room environment. These systems alert healthcare staff when a patient requires assistance or when a situation requiring assessment is detected.

KEIT works with an international team of approximately 30 surgeons, including 27 Italian surgeons, specialising in plastic surgery, otolaryngology, and oral and maxillofacial surgery. A distinctive feature of the clinic's organisation is that surgeons are selected according to their specialisation and experience in the specific procedure. For particularly complex operations, teams of two or more surgeons may be assembled.
For varicose veins, assessment and treatment require specific expertise in vascular medicine. The choice of procedure must be based on a clinical examination and duplex ultrasound mapping of the venous system, which helps identify the affected veins, the presence of venous reflux, and the anatomical characteristics of the superficial and deep venous circulation. Based on the findings, the specialist can determine whether techniques such as endovenous ablation, sclerotherapy, or varicose vein surgery are indicated.
The specialist's specific experience is particularly important for distinguishing predominantly cosmetic concerns from conditions associated with venous insufficiency and selecting treatment appropriate to the severity of the disease. The availability of vascular specialists and specific procedures at KEIT Day Hospital must be confirmed during the preliminary assessment.
KEIT Day Hospital surgeons regularly attend international congresses, training courses, and conferences to update their skills and keep abreast of scientific developments and surgical techniques within their respective specialities.

At KEIT Day Hospital, preparation for surgical procedures involves a structured medical assessment process. According to the clinic's protocol, every patient undergoing surgery has at least two consultations with the surgeon, an anaesthetic assessment, a cardiology consultation, blood and urine tests, and an electrocardiogram (ECG). These evaluations are coordinated within the facility, which has an in-house laboratory for preoperative testing. For outpatient varicose vein treatments, the necessary tests are determined according to the planned procedure and the patient's condition.
For varicose veins, the central element of the assessment is an examination of venous circulation in the lower limbs. Duplex ultrasound allows the specialist to assess valve function, identify any venous reflux, and determine whether the superficial and deep veins are affected. The consultation also includes an assessment of symptoms, the distribution of varicose veins, skin condition, and potential risk factors, such as family history, pregnancy, previous venous thrombosis, prolonged immobility, and cardiovascular disease.
This information helps distinguish cases requiring treatment from those for which clinical monitoring and conservative measures may be sufficient. Treatment planning considers both symptom relief and cosmetic improvement, avoiding unnecessary procedures and selecting the most appropriate approach for the individual patient.

KEIT Day Hospital follows infection control protocols developed in collaboration with infectious disease and microbiology specialists, involving systematic checks of the surgical environment and sterilisation processes. Air filtration systems undergo regular maintenance and replacement, while operating theatres are cleaned and disinfected after every procedure.
During surgery, single-use sterile kits and fluid-resistant materials are used to help maintain a sterile surgical field. Disposable materials have identification labels containing information about their manufacture, expiry dates, and traceability, which is recorded in the patient's medical documentation.
Surgical instruments are cleaned and sterilised after each use, following procedures documented through records generated by the equipment used. This system allows sterilisation processes to be verified and traced. The clinic also conducts regular microbiological testing of its facilities and follows antibiotic prophylaxis protocols when indicated by medical assessment.
Together, these measures, from the management of sterile materials to sterilisation traceability and microbiological monitoring, form a fundamental part of KEIT Day Hospital's procedures for reducing the risk of surgical infections.

At KEIT Day Hospital, surgical procedures requiring general anaesthesia are performed, according to the clinic's protocol, using TIVA (Total Intravenous Anaesthesia), a technique based on the intravenous administration of anaesthetic medications. Depending on the patient's characteristics and the anaesthetic protocol used, this technique may support recovery from anaesthesia and help reduce postoperative nausea and vomiting.
However, general anaesthesia is not always necessary for varicose vein treatment. Endovenous laser ablation is often performed under tumescent local anaesthesia, while sclerotherapy can be carried out without general anaesthesia. The choice depends on the procedure, the extent of the veins requiring treatment, and the patient's clinical condition.
During procedures requiring anaesthetic monitoring, the anaesthetic team monitors the patient's vital signs using General Electric equipment installed in all three operating theatres. The facility also has centralised systems for oxygen, compressed air, and medical suction, as well as difficult airway management devices, cardiac defibrillators, emergency medications, and backup power supplies for electricity and medical gases.
To manage potential emergencies, KEIT Day Hospital has a postoperative resuscitation room equipped with a ventilator, multiparameter monitors, a defibrillator, intravenous infusion pumps, and other life-support equipment. According to the clinic's reported records, this room has not yet been used to treat major complications, but it remains fully equipped and ready for use in the event of unforeseen situations.

At KEIT Day Hospital, patient care continues after the surgical procedure has been completed. For procedures requiring a hospital stay, patients are monitored and cared for by healthcare staff during the postoperative observation period. Following minimally invasive varicose vein treatments, patients may be discharged on the same day when their clinical condition allows.
According to the clinic's surgical care model, each patient is supported after discharge by four professionals: a coordinator, a nurse responsible for wound dressings, a doctor, and the operating surgeon. Follow-up appointments are generally scheduled at 1, 3, 6, and 12 months after surgery, with additional assessments depending on the procedure and clinical needs.
For varicose vein treatment, follow-up care allows the medical team to assess symptom improvement, healing of the treated areas, and changes in the appearance of the legs. After endovenous procedures or sclerotherapy, duplex ultrasound examinations may be scheduled when indicated to assess treatment results or investigate any symptoms. The doctor also provides guidance on mobilisation, the possible use of compression stockings, and returning to daily activities. The timing and frequency of follow-up appointments should be personalised, particularly for patients with more extensive venous disease or risk factors for thrombosis.
KEIT Day Hospital also provides patients with a 24-hour emergency contact number, available seven days a week, to request assistance if needed after surgery.

One of the defining features of KEIT Day Hospital's services is its emphasis on transparency and documentation throughout the surgical process. A complete medical record is prepared for every procedure, documenting preoperative assessments, the procedure performed, the techniques used, and information about postoperative recovery.
The clinic also uses photographs taken before and after treatment to monitor the development of the result, in accordance with personal data protection requirements and medical confidentiality. Every patient receives a service contract, a tax invoice, and an informed consent form, which is sent before the procedure so they have sufficient time to review information about the treatment, potential risks, benefits, and treatment alternatives.
KEIT Day Hospital also provides an Official Guarantee Certificate for surgical procedures to which it applies. This certificate defines the clinic's responsibilities and the conditions under which expenses are covered in the event of complications during or after surgery, as specified in the document. For varicose vein treatment, the applicability of the guarantee and its specific conditions must be confirmed before the procedure. The documentation allows patients to understand the terms and limits of any applicable coverage in advance.