Varicose veins are a disease that affects about a third of the world's population, which is a fairly large number. 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 carried out in clinics.
How were varicose veins treated in the past?
The problem of varicose veins has accompanied humanity since erection. It is known that not a single other species of mammal suffers from this pathology, so humans have been struggling with it for a long time, for example:
- A cave painting depicting people with bandaged feet was found in the Sahara. The painting is around 5, 000 years old.
- In the found medical manuscripts of Egypt there is information that it is not necessary to touch the dilated veins under the skin, but many healers still experimented on the wives of the pharaohs - they cauterized the diseased veins.
- The Indians of Central and South America used medicinal herbs, especially amaranth, to treat varicose veins.
- Information about this pathology can also be found in the works of the Greeks (Hippocrates, Herophilus and Erasistratus). It is noteworthy that the first of these doctors developed both conservative and surgical treatment methods.
- The Roman scientist Celsus used special hooks to combat pathologies (interestingly, the devices are still used today in the modern treatment of varicose veins, especially in miniphlebectomy).
- In China, it was common to combat 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" because in Europe there were many bans on operations ("interference in God's affairs") and the affected veins were usually 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 of this is a time of discoveries, including in medicine. 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 emerging.
In the 20th century, research into the laser procedure began and new, more effective treatment methods were developed. This process still continues without stopping for a minute. Of course, the way varicose veins are treated today is significantly different than in ancient times.
Modern methods of treating varicose veins
The latest methods of treating varicose veins are obliteration and coagulation of various types - these are the least traumatic procedures. Let's take a closer look at some modern methods of combating varicose veins.
Endovenous laser coagulation
This method is often referred to by the abbreviated name EVLC. The principle of operation is as follows: a laser light guide that heats the blood is inserted into the cavity of the diseased vein. This closes the vessels and turns the vein into connective tissue for a while. The process itself takes 20 to 30 minutes. After that, you may only need to wear special knitwear for 40 to 60 minutes. Further conservative and compressive treatment is determined by the doctor based on the medical history. This procedure can be performed on both lower extremities.
The advantages of this modern method of treating varicose veins are:
- Duration – only 20-30 minutes;
- During the manipulation, there is no need to cut, apply or remove sutures, since the procedure is carried out through puncture.
- painlessness (performed under local anesthesia) and safety;
- quick recovery (you can return to your normal life on the day of the procedure);
- minimal trauma, excellent aesthetic appearance after the procedure.
However, the treatment method also has contraindications, including:
- obesity in the legs;
- blood clotting disorder;
- extreme stage of the disease, for example, severe enlargement of the vein, which may require surgery or combination therapy;
- severe atherosclerosis of the arteries of the lower extremities, requiring a special approach;
- Intolerance to anesthetics used in EVLT;
- pregnancy and breastfeeding period;
- deep vein thrombosis in the acute phase;
- Inflammation at the lesion site;
In addition, EVLT is usually not prescribed if the patient can no longer move actively after the manipulation or if he suffers from a disease that makes it impossible to wear special stockings to prevent bruising or complications.
Radio frequency extinction
Another non-surgical modern way of treating varicose veins is radiofrequency obliteration, or RFO for short. The treatment is carried out using a radio frequency generator. So, sound waves penetrate through a special catheter with radiation, which heats and then narrows the vessel walls.
It should be noted 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 not only for varicose veins, but also for heart and kidney diseases.
RFO offers the following advantages:
- Painlessness (local anesthesia is used during application) and safety;
- Duration no more than 40 minutes;
- visible results after just 7 days;
- minimal trauma, excellent aesthetic appearance;
- complete "gluing" of the blood vessels;
- high efficiency;
- the ability to use this method if the patient has other diseases;
- No additional surgical procedure is required.
There are also contraindications to the use of this procedure. Including:
- inflammatory process at the site of the lesion;
- infectious and viral pathologies;
- Pregnancy and breast feeding period;
- venous thrombosis;
- severe atherosclerosis of the arteries of the lower extremities – as already mentioned, this pathology requires surgical intervention;
- allergic reaction to anesthetics used during the procedure.
In addition, a contraindication exists if the patient has a pathology that prohibits him from wearing compression stockings.
Steam destruction
This method is one of the newest in the history of medicine. The so-called "steam injection" combines EVLT and RFO. It is the least invasive compared to others and is now considered the most versatile of all. As with the procedures described above, steam sclerotherapy does not require additional hospitalization.
The most pleasant advantage of the method is the possibility of its application at any stage - this type of procedure can treat very deep veins. The fact is that steam penetrates the vessels very quickly and without any special obstacles and fills any bends in the veins.
The principle of the method is as follows: water under pressure is pumped into a pipe that is heated by electric current. As a result, the water changes its structure and turns into steam, which enters the vessel and is converted back into water. while the vessel walls absorb the heat generated by such simple manipulation.
Like the procedures described above, this manipulation does not last long. The patient recovers quickly and can return to his usual lifestyle after completing the procedure and wearing compression stockings for 30-40 minutes.
Mechanochemical extinction
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 lesion site. With its help, a device is introduced that damages the walls of blood vessels and thereby closes them. The manipulation occurs on the inside of the vein and therefore does not require anesthetics. At the end of the procedure, the puncture site is covered with a sterile bandage or napkin. In addition, the patient must wear compression stockings for 30-40 minutes.
Because obliteration does not require anesthesia, this method may be indicated if the patient cannot tolerate anesthetics. It is also recommended for people with a low pain threshold. In addition, this procedure can also be performed if the patient has trophic ulcers.
Fast rehabilitation, the ability to return to a normal lifestyle as quickly as possible, minimal restrictions during the recovery period - all these are the advantages of the above therapy method. The advantage of mechanochemical obliteration is the lower risk of infection due to minimal trauma.
Adhesive obliteration
Another procedure that may be recommended for patients with varicose veins is adhesive obliteration. What is noteworthy is the fact that after completing the manipulation there is no need to wear special knitwear.
Like the other methods described above, this method does not require any 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 caused by varicose veins (usually this is clearly visible on the lower leg). The procedure is also performed on patients with a large diameter of the affected veins (in contrast to the methods described above).
Which of the modern methods of treating varicose veins is the most effective?
All of the above methods of treating varicose veins are highly effective, however, each of them has its own characteristics, in which a specific procedure is recommended for a particular patient. If a person is contraindicated in wearing compressor stockings and/or has complications due to varicose veins, he is prescribed adhesive obliteration. In case of a possible allergic reaction to an anesthetic, a qualified specialist may prescribe mechanochemical obliteration.
In addition, the criteria for choosing the most suitable method for treating varicose veins are as follows:
- Safety, no unwanted reactions.
- Efficiency.
- Duration of storage of the result.
The last point is worth discussing 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 show (indicators in percent):
- 5 years after the procedure, the effectiveness of EVLT increases from 92. 9 to 95. 4. Compared to RFO, the effectiveness of this method decreases from 88. 9 to 79. 9 over 5 years.
- As for the results of surgical interventions, the effectiveness of this method decreases from 80. 4 to 75. 7 within 5 years. In the latter case, over a period of 5 years there is also a decrease in the effectiveness of sclerotherapy from 82. 1 to 73, 5 to observe. However, interventions such as surgery are usually prescribed when more effective treatment methods are not possible for varicose veins.
From the study, we can clearly conclude that EVLT is the most advanced and effective method of treating varicose veins today, since, unlike other methods with which the comparison was made, its effectiveness increases over time and does not decrease the other way around. It is worth noting that clinics carry out all the procedures mentioned in the article that can help the patient in the treatment of varicose veins.