Successful Treatment Case of Varicose Veins

Successful Treatment Case of Varicose Veins in a Woman with Arthritis and Osteochondrosis


In October 2020, a 79-year-old woman visited the clinic complaining of periodic bleeding from enlarged veins in her legs.


The patient also experienced numbness in her feet, knee pain, pain in the back of her thighs and calves, swelling, and leg cramps. Bleeding occurred in the lower third of both calves.

Due to the woman’s severe osteoarthritis and widespread osteochondrosis of the spine, movements were accompanied by sharp pain, leading to a sedentary lifestyle, which significantly worsened her condition. For the same reason, the patient could not wear compression stockings or bandage her legs with elastic bandages.


The woman has been suffering from varicose veins for many years. The disease progressed parallel to increased back pain and restricted movement. Over the past year, spontaneous bleeding occurred three times, with no associated injuries.

She was born in 1941 and spent her early childhood in the blockade of Leningrad. There were cold injuries to her legs (general hypothermia or frostbite).

Some of her relatives also have varicose veins.


Upon examination, varicose veins were noted in both legs in the area of the great saphenous vein and multiple enlarged veins in the lower third of the calves and feet. There were no trophic disturbances (visible skin defects/ulcers). The calves were swollen. Arterial pulsation in the legs remained satisfactory.

Duplex scanning of the leg veins showed:

  • Enlargement of the great saphenous vein on the right with insufficiency of the valves of the great saphenous vein throughout its length and at the sapheno-femoral junction;
  • Insufficiency of the perforating veins of both calves;
  • Patency of the deep veins without valve insufficiency.


  • Varicose vein disease of the legs. Chronic venous insufficiency I–II (moderate) degree. Recurrent bleeding from varicose veins of the calves.

Degenerative-dystrophic spine disease: widespread osteochondrosis with radicular symptoms. Deforming osteoarthritis of the knee and hip joints III (severe) stage.


In November 2020, endovenous laser coagulation of the right great saphenous vein was performed on the patient.

To alleviate neurological symptoms and pain syndrome, the neurologist prescribed:

  • Physiotherapeutic treatment for the lumbar region — laser therapy and electrostimulation;
  • Paravertebral blocks;
  • Infusion therapy — antispasmodics and drugs improving microcirculation;
  • Intramuscular injections — B-group vitamins.

After reducing the inflow of the right great saphenous vein, a course of foam sclerotherapy began in January 2021: foam sclerosant was injected into the enlarged veins of the legs and their tributaries, which destroyed the inner layer of the vessels and allowed them to close.

The woman underwent 4 procedures with an interval of 1–2 weeks. The treatment was complicated by the fact that the patient could not wear compression stockings.

After completing the therapy, the right great saphenous vein, veins of the calves and feet completely disappeared. Swelling and pain syndrome significantly decreased.

The patient continues to be monitored in the hospital. She has not reported any new complaints regarding her veins. There have been no recurrences of varicose vein disease or bleeding.


This clinical case demonstrates the importance of carefully addressing patient problems and accurately assessing intervention risks considering comorbidities. Collaboration with a neurologist allowed for the correct planning of treatment tactics, which led to excellent results.