Varicose veins are a disease that affects about a third of the world's population, which is no small thing. In this regard, the therapy of this pathology requires modern and effective solutions.
Medicine is developing, modern methods of treating varicose veins are appearing, which are less and less traumatic and invasive, which contributes to the rapid rehabilitation of the patient. Procedures of this type are performed in clinics.
How were varicose veins treated in the past?
The problem of varicose veins accompanies humanity from the moment man achieved erection. It is known that no species of other mammals suffer from this pathology, so humans have long struggled with it, for example:
- There is a cave painting found in the Sahara Desert that depicts people with bandaged feet and the painting is about 5, 000 years old.
- In medical manuscripts found in Egypt there is information that it is not necessary to touch dilated veins under the skin, but many healers still performed experiments on the wives of pharaohs: they cauterized diseased veins.
- The Indians of Central and South America used medicinal herbs, especially amaranth, to treat varicose veins.
- Information on this pathology can also be found in the works of the Greeks (Hippocrates, Herophilus and Erasistratus). What is noteworthy is that the first of these doctors developed both conservative and surgical methods of treatment.
- The Roman scientist Celsus used special hooks to combat pathologies (it is interesting to note that the devices are still used today for the modern treatment of varicose veins, in particular with miniphlebectomy).
- As for China, it was customary to fight diseased blood vessels with the help of leeches, acupuncture and cauterization.
- In Japan, special attention was paid to conservative treatment.
- It is not for nothing that the Middle Ages are called "dark", since in Europe there were many prohibitions related to operations ("interference in the affairs of God"), and the affected veins, as a rule, were simply cauterized.
- At the same time, medicine was actively developing in the Middle East: for example, the famous doctor Avicenna tightly bandaged diseased vessels (which today is used mainly for prevention or rehabilitation).
- The Renaissance, the New Age: all this is a period of discoveries, even in the medical field. Doctors are increasingly studying the principles of venous circulation. Scientists are developing various surgical methods, some of which are still used today, and new methods of sterile vein ligation are being created.
In the 20th century, the laser procedure began to be studied and new, more effective treatment methods were created. This process is still ongoing, without stopping for a minute. Of course, the way varicose veins are treated today is significantly different from how it was in ancient times.
Modern methods for the treatment of varicose veins
The latest methods of treating varicose veins are obliteration and coagulation of various types - these are the least traumatic manipulations. Let's take a closer look at some types of modern methods of combating varicose veins.
Endovenous laser coagulation
You can often find the shortened name for this method: EVLC. The operating principle is as follows: a laser light guide is inserted into the cavity of the diseased vein which heats the blood. As a result, the vessels are sealed, and for some time the vein turns into connective tissue. The process itself lasts 20-30 minutes, after which you may need to wear special knitwear for only 40-60 minutes. Further conservative and compressive treatment is decided by the doctor based on the medical history. This procedure can be performed on either lower extremity.
The advantages of this modern method of treating varicose veins are:
- duration – only 20-30 minutes;
- manipulation does not require cutting, applying or removing sutures, since the procedure is performed via puncture;
- painless (carried out under local anesthesia) and safe;
- quick recovery (you can return to normal life on the day of the procedure);
- minimal trauma, excellent aesthetic appearance after surgery.
However, the treatment method also has contraindications, including:
- leg obesity;
- blood clotting disorder;
- extreme stage of the disease, for example, pronounced dilation of the vein, which may require surgery or combined therapy;
- severe atherosclerosis of the arteries of the lower extremities, requiring a special approach;
- intolerance to anesthetic drugs used in EVLT;
- pregnancy and breastfeeding period;
- deep vein thrombosis in the acute phase;
- inflammation at the site of the lesion;
Additionally, EVLT is usually not prescribed if the patient is unable to actively move after manipulation or if he has an illness that makes it impossible to wear special socks to prevent bruising or any complications.
Radio frequency cancellation
Another modern type of non-surgical treatment for varicose veins is radiofrequency obliteration, or RFO. The treatment is carried out using a radio frequency generator. Therefore, sound waves enter through a special catheter with radiation, which heats and thereby narrows the walls of the vessel.
It is worth noting that the vein is completely sealed, after the procedure it is enough to treat the manipulation site with an antiseptic and apply a sterile bandage. The peculiarity of this method is that the procedure can be prescribed for heart and kidney diseases, and not only for varicose veins.
RFO has the following advantages:
- painless (local anesthesia is used during application), as well as safety;
- duration not exceeding 40 minutes;
- visible results after just 7 days;
- minimal trauma, excellent aesthetic appearance;
- complete "adhesion" of blood vessels;
- high efficiency;
- the ability to use this method if the patient has other diseases;
- no additional surgery is required.
There are also contraindications to the use of this procedure. Between them:
- inflammatory process at the site of the lesion;
- infectious and viral pathologies;
- pregnancy and breastfeeding;
- venous thrombosis;
- severe atherosclerosis of the arteries of the lower extremities - as already indicated, this pathology requires surgical intervention;
- allergic reaction to the anesthetics that will be used during the procedure.
Furthermore, a contraindication is the circumstance in which the patient has a pathology that prevents him from wearing compression stockings.
Steam annihilation
This method is one of the most recent in the history of medicine. The so-called "vapor injection" combines EVLT and RFO. It is the least invasive - compared to others - and is today considered the most versatile of all. As with the procedures described above, steam obliteration does not require additional hospitalization.
The most pleasant advantage of the method is the possibility of using it at any stage: with this type of intervention it is possible to treat very deep veins. The fact is that the steam penetrates very quickly and without particular obstacles into the vessels, filling any bends in the veins.
The principle of the method is as follows: water under pressure is pumped into a pipe, which is heated by electric current, and thus the water changes structure, turning into steam, which enters the vessel, where it is again converted into water, while the vascular walls absorb the heat generated by this simple manipulation.
Like the procedures described above, this manipulation also does not last long. The patient recovers quickly and, after completing the process and wearing compression stockings for 30-40 minutes, can return to his usual lifestyle.
Mechanochemical annihilation
It combines a mechanical effect on the walls of blood vessels and treatment of the patient with chemicals. After a small puncture, a special catheter is placed at the site of the lesion. With his help, a device is inserted that damages the walls of the blood vessels, thus sealing them. The manipulation is carried out on the internal surface of the vein and therefore does not require the use of anesthetics. At the end of the procedure, the puncture site is covered with a sterile bandage or napkin. Additionally, the patient should wear compression stockings for 30-40 minutes.
Since obliteration does not require anesthesia, this method may be indicated if the patient is intolerant to anesthetics. It is also recommended for people with a low pain threshold. Furthermore, this procedure can be performed even if the patient has trophic ulcers.
Quick rehabilitation, the ability to return to a normal lifestyle as soon as possible, minimal restrictions during the recovery period - all these are the advantages of the above therapeutic method. The advantage of mechanochemical obliteration is the reduced risk of infection due to minimal trauma.
Adhesive obliteration
Another procedure that may be recommended for patients with varicose veins is called adhesive obliteration. It is noteworthy that once the manipulation is completed there is no need to wear special knitwear.
Like the other methods described above, this method does not require incisions: a special glue is injected into the lumen of the diseased vessel, which seals the internal walls and redirects blood circulation through healthy veins.
This method of therapy can be prescribed to patients who have a complication due to varicose veins (as a rule, it is clearly visible on the lower leg). The surgery is also performed for patients with affected veins of large diameter (unlike the methods described above).
Which of the modern methods of treating varicose veins is the most effective?
All of the above methods for treating varicose veins are highly effective, but each of them has its own characteristics, where a specific procedure is recommended for a particular patient. If a person is contraindicated to wear compression stockings and/or has some complications due to varicose veins, he or she will be prescribed adhesive obliteration. If there is a possible allergic reaction to any anesthetic, a qualified specialist can prescribe mechanochemical obliteration.
Furthermore, the criteria for choosing the most suitable method for the treatment of varicose veins are as follows:
- Safety, absence of unwanted reactions.
- Efficiency.
- Duration of saving the result.
It is worth talking about the last point separately, since this criterion is very indicative of one of the analyzes based on the results of 119 studies comparing RF, surgery, sclerotherapy and EVLT.
As a result, these results (indicators in percentages) show that:
- 5 years after the procedure, the effectiveness of EVLT increases from 92. 9 to 95. 4. When compared with RFO, the effectiveness of this method decreases over 5 years from 88. 9 to 79. 9.
- As for the results of surgery, the effectiveness of this method decreases from 80. 4 to 75. 7 in 5 years. In the latter case, over 5 years one can also notice a decrease in the effectiveness of sclerotherapy from 82. 1 to 73. 5, however, procedures such as, for example, surgery are usually prescribed in cases where it is impossible to use more effective treatment methods varicose veins.
From the study we can clearly conclude that today the most progressive and effective method for the treatment of varicose veins is EVLT, since, unlike other methods with which the comparison was made, its effectiveness increases over time and not vice versa decreases. It is worth noting that the clinics perform all the procedures indicated in the article that can help the patient in the treatment of varicose veins.