Varicose veins are a pathology known since ancient times and numerous treatments have been applied for their elimination. The technique commonly applied during the last 100 years has been phlebectomy or the removal of varicose veins. This procedure proposed in the early 1900s by Babcock has been widely applied with acceptable results.
Evolution in the treatment of varicose veins
From the 1980s onwards, a real revolution took place when a French doctor (Franceschi) published the theory of treatment using the CHIVA strategy. The most important aspect of this new technique was that it was considered essential to use Doppler ultrasound to perform a thorough analysis of the venous circulation. This mapping made it possible to propose a treatment strategy aimed at preserving the internal and external saphenous vein.
These veins, until then, had been considered the culprits at the origin of varicose veins and had therefore been the veins to be removed almost systematically. Thanks to the development of the CHIVA strategy and the standardization of the use of ultrasound for venous circulation, increasingly less aggressive treatments have been developed. These treatments are known as “minimally invasive” (MIS).
The most popular IMT are the radiofrequency system, the endolaser and sclerosis using sclerosing foam. The endolaser and radiofrequency are based on the application of a heat source that ultimately eliminates or disables the internal saphenous vein. On the other hand, sclerotherapy is a treatment classically used in smaller varicose veins and which bases its effect on the progressive drying or fibrosis of the vein when it is injected. Other procedures have also been developed that use catheters that, instead of a heat source, use the same sclerosing liquid associated with the scratching effect of the vein. The most modern treatment we currently have is based on the application of glue inside the vein. This technique is completely painless and can be performed at any time of the year as it does not require wearing elastic stockings and does not produce skin pigmentation.
Today there are many different systems and procedures to treat varicose veins, most of which are intended to be non-aggressive, avoiding injury to the skin.
Foam sclerotherapy, the most versatile treatment
The variety of available techniques allows the specialist in Angiology and vascular surgery to choose, in each case, the best treatment. It is important to emphasize that each person has or may have different anatomical situations, may have different social or occupational needs. This diversity of pathologies and patients allows different strategies to be developed and a tailor-made suit to be made for each patient.
However, of all the techniques it is important to highlight the foam sclerotherapy treatment. This treatment is the only one that can be applied to practically all types of varicose veins, whether small or large. It is also the least aggressive technique, since it is performed in the office and does not use any type of analgesia, as it is completely painless. The only thing to bear in mind is that it is a progressive treatment, the results of which appear after several sessions. This may be a disadvantage compared to other techniques that have a faster effect but require surgery and some type of anesthesia.
Minimal risk of varicose vein removal techniques
There is no treatment that does not have possible adverse effects. However, when we talk about adverse effects or complications, specifically in the treatment of sclerotherapy, they are very rare and refer more to some aesthetic problems.
With regard to endovenous techniques, the possible complications are related to the effect of the heat on the tissues or to the extent of the occlusion effect.
Currently there are clinical guidelines that define very well how safe practices should be and following them the probability of complications is very infrequent.
Advantages of minimally invasive treatments to eliminate varicose veins
All these IMTs offer the patient greater comfort in all aspects. These techniques allow almost immediate reincorporation to daily and work tasks. They usually minimize wounds or scars on the skin, which favors the most optimal aesthetic result.
In general, it can be stated that in the world of phlebology and, specifically, in the treatment of varicose veins, all these types of strategies are here to stay and professionals who do not adapt to them will gradually lose competitiveness, since the patient will demand them.