Varicose veins are a disease that affects approximately a third of the world's population, which is quite a lot. In this sense, the therapy of this pathology requires modern and effective solutions.
Medicine develops, modern methods of treating varicose veins appear, increasingly 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 the moment he (man) acquired an erection. It is known that not a single species of other mammals suffers from this pathology, which is why man has been fighting against it for a long time, for example:
- There is a cave painting found in the Sahara Desert that depicts people with bound feet, and the painting is approximately 5, 000 years old.
- In the medical manuscripts found in 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, particularly amaranth, to treat varicose veins.
- Information about 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 treatment methods.
- The Roman scientist Celsus used special hooks to combat pathology (interestingly, the devices are still used to this day for the modern treatment of varicose veins, in particular, with miniphlebectomy).
- As for China, it was customary 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", since in Europe there were many prohibitions related to operations ("interference in God's affairs"), 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 mainly used for prevention or rehabilitation).
- The Renaissance, the New Age: all this is a period of discoveries, even 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 being created.
In the 20th century, the laser procedure began to be studied and new and more effective treatment methods were created. This process continues, without stopping for a minute. Of course, the treatment of varicose veins today is very different from that of ancient times.
Modern methods of treating varicose veins.
The newest methods of treating varicose veins are obliteration and coagulation of various types; These are the least traumatic manipulations. Let us consider in more detail some types of modern methods of combating varicose veins.
Intravenous laser coagulation
You can often find the abbreviated name of this method - EVLC. The principle of operation is as follows: a laser light guide, which heats the blood, is placed in the cavity of the diseased vein. As a result, the vessels become sealed and for some time the vein turns into connective tissue. The process itself lasts 20-30 minutes, after which you may only need to wear special knitwear for 40-60 minutes. Conservative and additional compression 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;
- The manipulation does not require cutting, applying or removing sutures, since the procedure is performed by puncture;
- painless (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 intervention.
However, the treatment method also has contraindications, including:
- obesity in the legs;
- 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 lactation period;
- deep vein thrombosis in the acute phase;
- inflammation at the injury site;
In addition, EVLT is usually not prescribed if the patient cannot actively move after manipulation or has a disease that makes it impossible to use special stockings to prevent bruising or any complications.
Radiofrequency obliteration
Another modern type of non-surgical treatment for varicose veins is radiofrequency obliteration or RFO. The treatment is performed through the use of a radiofrequency generator. Thus, sound waves enter through a special catheter with radiation, which heats and then 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:
- painlessness (local anesthesia is used during application), as well as safety;
- duration no more than 40 minutes;
- visible results after only 7 days;
- minimal trauma, excellent aesthetic appearance;
- complete "adhesion" of blood vessels;
- high efficiency;
- the possibility of using this method if the patient has other diseases;
- no additional surgical intervention is required.
There are also contraindications to the use of this procedure. Among them:
- inflammatory process at the site of injury;
- infectious and viral pathologies;
- pregnancy and lactation;
- 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 that the patient has a pathology that prohibits him from wearing compression stockings.
Steam obliteration
This method is one of the newest in the history of medicine. The so-called "vapor injection" combines EVLT and RFO. It is the least invasive -compared to others- and today it is 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: very deep veins can be treated with this type of intervention. The fact is that the steam penetrates very quickly and without special obstacles into the vessels, filling the possible bends of the veins.
The principle of the method is as follows: pressurized water is pumped into a tube, which is heated by electric current, and thus the water changes its structure, turning into steam, which enters the container, where it is converted back into water. while the vascular walls absorb the heat generated by such 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, he can return to his usual way of life.
Mechanochemical obliteration
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 injury site. With its help, a device is inserted that damages the walls of the blood vessels, thereby sealing them. The manipulation is performed on the inner 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 must 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. In addition, this procedure can also be performed 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 method of therapy. 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 notable for the fact that after the manipulation is completed, it is not necessary 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 inner walls and redirects blood circulation through healthy veins.
This method of therapy can be prescribed to patients who have a complication of varicose veins (as a rule, it is clearly visible on the lower leg). The intervention is also performed in patients with a large diameter of the affected vein (unlike 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, but each of them has its own characteristics, in which a specific procedure is recommended for a particular patient. If a person is contraindicated to use compression stockings and/or has some complications from varicose veins, adhesive obliteration will be prescribed. If there is a possible allergic reaction to any anesthetic, a qualified specialist may prescribe mechanochemical obliteration.
Furthermore, the criteria for choosing the most appropriate method to treat varicose veins are the following:
- 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. Compared with RFO, the effectiveness of this method decreases in 5 years from 88. 9 to 79. 9.
- As for the results of surgical intervention, the effectiveness of this method decreases from 80. 4 to 75. 7 in 5 years. In the latter case, a decrease in the effectiveness of sclerotherapy from 82. 1 to 73. 5 can also be observed over 5 years, however, procedures such as surgery are usually prescribed in cases where for which 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 to treat varicose veins is EVLT, since, unlike other methods with which the comparison was made, its effectiveness increases over time, and not the other way around. , 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.