vein treatment

vein treatment



 Treatment with sclerosing injections for varicose veins
Varicose veins are enlarged and bulging veins, usually located in the legs. They can cause pain, burning sensation, pain and itching as well as generalized pain, heaviness or swelling, night cramps and restlessness in the legs. There is also little correlation between these symptoms and the degree or size of varicose veins that, like venous changes in the form of microvaries or telangiectasias, may be aesthetically unattractive. The use of graduated compression stockings is a treatment option.

Treatment with sclerosing injections can be used for superficial varicose veins, residual or recurrent varicose veins after surgery and microvaries to obliterate the varicose vein. An irritant liquid such as sodium tetradecyl sulfate (STD) is injected into the defective blood vessel. Subsequently, compressive dressings can be applied at the injection site and compressive bandages, among which options include crepe bandage, commercial elastic bandage or compression stockings. The bandage may cause discomfort and swelling of the foot or it may become loose. Possible complications of sclerosing treatment include: formation of blood clots, skin spots, inflammation, ulcers and tissue damage and reactions to the sclerosing agent.

In the review, 17 randomized controlled trials with more than 3 300 people were included. A study comparing sclerosing treatment with compression stockings during pregnancy found that sclerosing treatment improved symptoms and aesthetic appearance. There was no general benefit when using the alternative STD agents (four tests), or no evidence that the foam is superior to the liquid (two tests). In one study, a local anesthetic was added to the sclerosing agent and the pain of the injection was relieved. Neither the type, nor the duration of the elastic compression (seven studies) or the type of compressive dressing (one study) after the sclerosing treatment had any clear effect on the effectiveness of the treatment, in recurrence rates of varicose veins, aesthetic appearance or Symptomatic improvement, or complications. Many of the included studies were conducted in the 1980s and there is very limited evidence on the evaluation of the merits of sclerosing treatment for the treatment of varicose veins or the comparison of graduated compression stockings with sclerosing treatment. There were no controlled trials comparing sclerosing treatment for microvarials with laser treatment or simple observation; In one study, hypertonic dextrose had a similar efficacy in terms of sclerosis than STD.

Conclusions of the authors:
Tests of RCTs indicate that the choice of sclerosant, dosage, pharmaceutical form (foam versus liquid), local compressive dressing, the degree and duration of compression have no significant effect on the efficacy of sclerosing treatment for varicose veins. . The evidence supports the place currently occupied by sclerosing treatment in modern clinical practice, a place that is generally limited to the treatment of recurrent varicose veins after surgery and microvarials. The comparison surgery versus sclerosing treatment is the subject of another Cochrane review.