TREATMENT OF VARICOSE VEINS

Chronic venous insufficiency has a high incidence in the current western population. Varicose veins of the lower extremities are the most frequent vascular problem, which affects 30% of women and 20% of men.

To achieve effective and lasting results in the treatment of varicose veins it is essential to eliminate the origin of venous reflux. Varicose veins of the lower extremities have their origin in the circulatory insufficiency of the internal saphenous vein and external saphenous vein.

For this reason, the irrigation of these veins is usually the first therapeutic target. To treat venous hypertension the only effective and lasting treatment has been for years the ligation of the saphenous-femoral arch and stripping of the VSI. But in the last decade the medical and technological development has allowed the involvement of new minimally invasive techniques such as intravenous radiofrequency (VNUS Closure) and the venaseal system.

Sclerosis of varicose veins with foam.

Varicose vein sclerosis is a very little invasive technique that involves puncturing the dilated veins of the lower limbs (varicose veins or varicules if they are small) and introducing an irritating product with high permanence inside the vein (in the form of foam) in order to thrombus that vein and end up disappearing.

It has the advantage of not requiring anesthesia, incisions or closing points of any kind, so it is easily achievable. The incorporation into normal activities is very fast. Sometimes it can leave pigmentation of the clot that forms inside the vein and transmits its coloration to the skin, so the recommended indication is for small and medium sized varicose veins as well as, in some cases, vascular spiders.

The risks are minimal and can only cause skin necrosis in those sessions that produce an excess of the sclerosant or very powerful sclerosing agents are used. In case of hypersensitivity to the product this technique should be avoided.

In general, the results are very fast or almost immediate, even when they are performed. On other occasions, those same veins, once again filled with blood and coagulated, suffer a small inflammatory process, a transient phlebitis that takes a few weeks for complete resolution.

Often this type of small varicose veins should be studied sonographically to assess whether they come from a major vein problem that requires other techniques for resolution. Otherwise, when they exist in a very dispersed and branched way, the patient has to be aware that the number of sessions may be high and the solution may not be final, requiring new actions in the future.

            

Vascular spiders treated with sclerosis (foam).

Vascular spiders and reticular varicose veins treated with sclerosis (foam).

TREATMENT OF CHRONIC VENOUS INSUFFICIENCY (VARICOSE VEINS) THROUGH THE RADIOFREQUENCY(RF) PROCEDURE

The radiofrequency consists of electric and magnetic waves that when they come into contact with a tissue produce vibration and friction in their atoms, transforming into thermal energy that raises the temperature. This causes the desired effects on the vein to be treated:

  • Endoletial Destruction
  • Collagen denaturation and contraction
  • Shortening and thickening of the venous wall
  • Reduction of vessel light

In short, it manages to make the varicose vein disappear by atrophy. Radio frequency has proven to be an effective treatment with ultrasound success and high patient satisfaction.

Varicose veins treatment: radiofrequency vs stripping

Various analyzes have been performed with varicose veins patients to compare the efficacy of radiofrequency with stripping, the prior art. In the comparisons it has been shown that radiofrequency offers equally effective results, faster and with a shorter recovery time. Stripping on the other hand offered higher morbidity figures weeks after treatment, especially as regards the appearance of bruises, schimosis and pain.

The efficacy of both techniques was compared again two years after treatment, and in both cases the efficacy is lasting, with a lower recurrence rate for radiofrequency (14%) than for stripping (30%).

The minimally invasive radiofrequency technique was also compared with conventional surgery against varicose veins, and the results reflected a clear advantage for radiofrequency: less intervention time, less pain, less schimosis and less recovery time to return to work routine.

Radiofrequency Procedure to remove varicose veins

The intravenous radiofrequency ablation intervention uses an RFG generator and a ClosureFast catheter, a device that improves the efficiency and reduces the ablation time of the previous option.

The radiofrequency varicose vein removal procedure is fully eco-assisted. Prior to the intervention, you should perform a Doppler ultrasound marking from the groin to the ankle to indicate the sections with complications.

The procedure requires the use of local tumescent anesthesia, that is, by means of an eco-guided injection of the Klein solution at the perivenous level. It is carried out with this anesthesia with a triple purpose:

  1. Protects the skin and nearby structures against radiofrequency heat
  2. Analgesia
  3. Promote the collapse of the veins

Access to the varicose vein to be treated can be surgical through a small incision or percutaneous using the Seldinger technique.

At the end of the intervention, the angiologist should keep an ultrasound follow-up of the treated area, as well as a control with Eco-Döppler during the first days after treatment to rule out possible complications.

Radiofrequency, the best treatment for varicose veins

The intravenous radiofrequency ablation VNUS Closure FAST is currently a technique that has proven to be safe and effective in the removal of varicose veins, with high patient satisfaction. With a faster recovery time, it allows you to join the normal routine before and has no bruising or pain.

Radiofrequency has demonstrated its superiority over previous treatments, as well as in the case of the endolaser, the other most common option of minimally invasive treatment for varicose veins.

Complications such as venous thrombosis, skin burns and neuritis with this technique are very rare. Even so, to prevent them, the patient should be put in the hands of a specialist with experience in techniques such as infiltration of tumescent anesthesia or Doppler ultrasound, which is essential for an optimal procedure and proper follow-up of the patient after treatment.

              

Radiofrequency of varicose veins. Before and after treatment.

TREATMENT OF VARICES WITH THE VENASEAL SYSTEM

VenaSeal or cyanoacrylate is a medical glue used to seal the saphenous vein, the vein that runs through the inside of the leg from the foot to the groin.

Treatment of varicose veins with VenaSeal, what does it consist of?

Treatment with VenaSeal seeks to seal the vein to remove the varicose vein. The first thing that is done is to locate the vein by Doppler ultrasound and, under local anesthesia only in the puncture area, a small incision (2 mm) is made and a catheter is inserted. Always under ultrasound vision, we advance that catheter to near the mouth of the saphenous vein in the deep veins. From there, through a sophisticated controlled release system, the VenaSeal is deposited along the entire vein, gradually removing the catheter to the place where we have introduced it.

Advantages of VenaSeal over conventional surgery:

  • Does not leave scars, bruises, or spots. Sealing with cyanoacrylate does not make traction or tearing of the veins, but only a release of glue inside so it does not leave marks
  • For this same reason, the saphenous nerve that goes along with the vein is not damaged, avoiding the typical crushing that occurs many times after conventional surgery.
  • In addition, all treatment is performed under ultrasound vision, ensuring at all times the result and the patient does not require hospital admission, being able to go home walking as soon as the procedure is performed.
  • Having an immediate effect, you do not need bandages or compression stockings.
  • It can be done in summer.

Should some care be followed after treatment?

 

No special care is really necessary. Since it is not a painful technique, it is not necessary to take anti-inflammatories or analgesics. Nor should heal scars as it is done by puncture. Nor is it necessary to wear compression stockings or limit physical activity. Even so, we always offer a 24-hour telephone and an email to our patients to answer any questions during the postoperative period.

Is it an outpatient intervention?

Yes, the intervention does not require hospitalization.

It is done completely on an outpatient basis. You don’t need an operating room to carry it out.

Performs a Doppler ultrasound of venous marking, intervenes and an hour later the patient goes home, immediately joining his daily life, without varicose veins and without compression stockings.

Are the results of VenaSeal final?

Yes. The results of studies carried out both in Germany and in the United States show that sealing with cyanoacrylate is at least as effective as alternative endovascular thermal energies, achieving success rates at 2 years (complete sealing of the persistent vein over time beyond 2 years) over 98%. It should be taken into account that this system is based on the use of cyanoacrylate for sealing brain aneurysms and the rest of the body and for arterial embilization in cases of bleeding. Techniques widely used for many years and with proven success over time.

         

Venaseal system. Before and after treatment.

If you have any questions or concerns about the treatment of any type of varicose veins without surgery, and without anesthesia call us and we will clarify them.

About the Author :

START TYPING AND PRESS ENTER TO SEARCH