Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 1, January-February, p. 5–14

doi: 10.17219/acem/31880

Publication type: editorial

Language: English

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Varicose Veins of Lower Extremities, Hemodynamics and Treatment Methods

Maciej Chwała1,D, Wojciech Szczeklik2,E,F,A, Michał Szczeklik3,E, Tomasz Aleksiejew-Kleszczyński4,E, Maria Jagielska-Chwała5,E

1 Clinical Department of Vascular Surgery, University Hospital, Kraków, Poland

2 Allergy and Immunology Clinic, University Hospital, Jagiellonian University Medical College, Kraków, Poland

3 Department of Cardiothoracic Surgery, London Chest Hospital, London, United Kingdom

4 Vascular Surgery Medical Centre, Kraków, Poland

5 Vascular Centre, St. John Grande Hospital, Kraków, Poland

Abstract

Chronic venous insufficiency is one of the most common disorders of the vascular system, affecting approximately 50% of adults. If left untreated it can lead to a number of complications, including venous ulceration and venous thrombosis. This review paper outlines the epidemiology and ethiopathogenesis of the disease with regard to hemo- dynamics and microcirculation disturbances. It describes the medical treatment as well as the traditional surgical approach to varicose veins (with several modifications of this technique), and its limitations and contraindications. Furthermore, it discusses a number of new, minimally invasive treatment methods, namely thermal in form (radio- frequency ablation, endovenous laser ablation, steam ablation) and nonthermal (sclerotherapy, echosclerotherapy, Clarivein, Sapheon). For each method, there is a brief historical overview, a description of its mechanism of action, and its indications and limitations. The results of comparative studies on individual treatment methods as well as meta-analyses on this topic are briefly discussed. This paper highlights the progressive trend towards minimally invasive methods and attempts to predict the further development 

Key words

varicose veins, laser ablation, radiofrequency ablation, sclerotherapy, surgical management of varicose veins.

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