Nowadays it can be said that it is not necessary to undergo surgery to get rid of varicose veins, no matter what size they are. Likewise, we can also say that sick leave is no longer necessary after novel varicose vein treatments. The concept underlying this revolution is that we have changed from “ripping out” diseased veins to “cancelling” those same veins and letting our own body do the rest.

Vascular surgery is one of the fields of medicine that has changed the most in recent years. Classic scalpel and stitch surgeries have been replaced by less invasive, image-guided procedures, in which it is not necessary to open a wound. As I usually say, we have changed from “having to cut into the wall to fix the pipe, to fixing it from the tap hole using a cable without having to break the wall.”

The veins constitute the return circulation of blood to the heart, and if the valves inside them are damaged, that blood circulates in the opposite direction, making it much more difficult for it to reach its destination. These valves are damaged for several reasons, mainly hereditary, hormonal and occupational factors (jobs that require long periods of standing).

By eliminating veins that do not function properly and making blood circulate only through those that do, we improve circulation in the legs. Contrary to what it may seem, canceling these veins is very beneficial. Numerous methods have been developed, the most established and proven are:

-Sclerosis with microfoam guided by ultrasound: it consists of injecting a volume of foam at the same time that we look with the ultrasound, this way we choose exactly the veins that need to be treated. This causes the veins to become diseased, become useless (blood no longer circulates) and the body makes them disappear. It is used for bulging and tortuous veins.

-Ablation of the saphenous vein using different types of catheters: The saphenous vein that was classically removed is currently rendered useless using catheters (laser, radiofrequency, Clarivein®, Venaseal®,…). The laser and radiofrequency heat the vein until it is covered, the Clarivein® produces a scraping that also makes the saphenous vein disappear and finally the Venaseal® deposits a glue, such as the well-known superglue, inside the vein and occludes it. .

In this new approach to the management of varicose disease, a good diagnosis made with color Doppler ultrasound is essential. We recommend visiting a vascular surgeon who, after making the precise diagnosis, will tell you which of the new techniques can help you.

Signed Octavio Cosín Sales. Angiology and Vascular Surgery

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