My specialty, Angiology and Vascular Surgery, has changed a lot in recent years. Surgical interventions on the aorta artery, for example, have always been characterized by large procedures, which entailed an enormous medical-surgical aggression on the patient.
Over the last 20 years, less and less aggressive techniques have been progressively introduced. The aim is to provide a solution to vascular problems (whether dilatation, stenosis, obstruction, rupture, dissection) by means of procedures performed by navigating inside the vessels, both arterial and venous, and are therefore called endovascular.
Endovascular procedures greatly reduce the aggressiveness of interventions in many aspects: fewer incisions, fewer dissections, shorter surgical time, shorter hospital stay; therefore, in short, fewer complications and lower risk of morbidity and mortality.
Endovascular Surgery Applications
Unfortunately, not all patients can benefit from this type of surgery. Endovascular surgery still has various limitations. For example, some of the materials used need to be progressively improved. The future and research are currently moving towards biodegradable materials.
There are vascular sectors where classic surgery is very well consolidated, with excellent results, which for the moment endovascular techniques have not been able to overcome. For example, there are vascular lesions that, due to their complexity (extension, degree of stenosis/obstruction, associated calcification, etc.), make the use of endovascular techniques inadvisable, due to inadequate experience and results to date. In other cases, there are very extensive aneurysmal lesions, especially of the aorta artery, which may require mixed or hybrid techniques.
In short, it is very important to master all the techniques in order to be able to individualize and choose the most appropriate treatment for each patient.
Endovascular techniques to treat varicose veins
Of course, the field of varicose veins has also benefited significantly with the advent of these techniques. Most varicose veins have their origin in a valvular incompetence and reflux of the internal/external saphenous vein. Traditional surgery, or saphenectomy, consists of a radical elimination of this vein.
Today, endovascular techniques make it possible to correct this reflux by means of devices that navigate inside the vein, such as the endolaser, radiofrequency or the clarivein system.
What is the clarivein system?
This is an endovascular technique that simultaneously associates a mechanical and chemical ablation system. As it is not a thermal ablation generating heat (like endolaser and radiofrequency) it does not require anesthesia nor does it have the potential risk of neurological injury.
In our centers, we can treat any type of varicose vein combining the clarivein device and microfoam sclerotherapy, thus achieving an ambulatory technique, very little aggressive, which does not require surgical incisions or anesthesia.