Técnicas endovasculares en el tratamiento de la insuficiencia venosa superficial. Mecanismo de acción, procedimientos, indicaciones y efectos adversos

Abstract

Introduction and objective

Chronic venous disease is the most common entity of vascular pathology and varicose veins originating in the saphenous trunks can cause significant morbidity. Endovascular treatment offers significant advantages, being at least as effective as surgery.

Methods

Review of thermal (laser, radiofrequency, steam and microwave) and non-thermal (cyanoacrylate, ultrasound-guided foam and mechano-chemical) endovascular techniques in the treatment of superficial venous insufficiency based on existing literature and own experience.

Results

Throughout the article, each of the techniques, their mechanism of action and the commercial devices available with standard use procedures are described. Likewise, the usual postoperative period for each of them, precautions, contraindications, results described in the literature, and frequent and uncommon complications are detailed. After the description of the techniques, the results of endovascular techniques are compared with conventional surgery (high ligation/stripping) and endovascular techniques with each other. Finally, a guide is provided for selecting the best treatment based on the characteristics of the patient, its indications and known limitations, according to the latest clinical guidelines and reviews.

Conclusions

Endovascular treatment has become the current standard. Although thermoablative techniques are the first indication, non-thermal treatments are a good alternative depending on the clinical context and some such as cyanoacrylate may become first choice therapy in the future.