An innovative American treatment method, known as mechano-chemical vein ablation, has recently entered Bulgaria, said in an interview for "Doctor" Dr. Angel Radev - specialist in angiology, part of the team of MBAL "Nadezhda"”, where he created a sector of angiology and mini-invasive treatment of varicose veins. He worked in the Department of Vascular Surgery and Angiology of the National Cardiology Hospital, in Tokuda Hospital and City Clinic. The main focus of Dr. Radev's work is the minimally invasive treatment of varicose veins, vascular diagnostics, the prevention and treatment of arterial and venous diseases, as well as the screening and prevention of atherosclerosis. He specialized in the USA and Germany in the field of modern treatment of venous diseases
Dr. Radev, let's start with this - is the incidence of varicose veins high?
- Varicose veins are one of the most common diseases in the industrialized countries of Europe and North America, and this ranks them with socially significant diseases, such as arterial hypertension and diabetes mellitus. According to statistics, about 30% of the human population worldwide suffers from varicose veins to one degree or another. For Bulgaria, statistics indicate that between 30-40% of women and about 20% of men have some form of chronic venous disease. However, the disease wrongly remains out of the attention of both patients themselves and medical professionals. A solution to the problem is sought only in the advanced stages of the disease, when the sufferer's quality of life is severely impaired. In recent years, due to the rapid development of high technologies, the change in the work regime and the lifestyle of many people, the frequency of venous diseases is growing, and it is predicted that this trend will hardly change in the future.
You say that this disease is neglected by both patients and medical professionals. On that note, what don't people know about him?
- In fact, varicose veins are as widely known and widespread as they are an unknown and shrouded in myths and misconceptions problem. The main misconception among people is that varicose veins are mainly treated surgically, which is also the reason why many patients are afraid to solve their problem. The truth is that modern clinics around the world have been treating varicose veins mostly non-operatively for years. Fortunately, in Bulgaria we are already very successfully applying modern technologies in the treatment of chronic venous disease. Unfortunately, there are still few places in our country where patients can receive really high-quality treatment according to the most modern world standards.
Dr. Radev, are there risk groups of people for the disease of varicose veins?
- The truth is that chronic venous disease is an age-related disease.
With advancing age, the frequency of the disease seriously increases, but this definitely does not mean that it does not occur in young people. Personally, I have also had 18-19 year old patients. Among the risk groups are people practicing professions related to prolonged standing or sitting, with a lack of movement - for example, office workers, programmers, surgeons, hairdressers, drivers, accountants, etc. However, the number one factor remains heredity, i.e. if your parents suffer from varicose veins, it is very likely that you too will develop the problem one day. As other risk and predisposing factors, I can mention the intake of hormonal preparations, as well as the period of pregnancy.
How do the new bloodless methods for treating varicose veins differ from the already known ones?
- In the last decade, the treatment of varicose veins has changed completely, as many new methods have entered daily practice. Modern technologies now allow us to treat damaged veins without general or spinal anesthesia, without incisions, stitches and hospital stay, using only a small 2-3 mm hole in the leg. The treatment is extremely gentle, and the patient can return to work the very next day. This is not the case with the old surgical treatment, which is associated with a much longer recovery period and more risks of potential complications.
What bloodless methods do you use?
- In my practice, I mostly apply the so-called laser ablation, in which a special catheter is used to treat the damaged vein. In this method, only a special type of local anesthetic is applied - the so-called tumescent anesthesia. Another widely used and very effective method is sclerotherapy, in which a special substance is injected inside the damaged veins, which causes the vein wall to stick together. An innovative American method of treatment, known as mechano-chemical vein ablation, has recently entered Bulgaria. This method does not require the application of even local anesthesia, which increases the patient's comfort and further shortens the duration of the procedure.
What is your opinion and attitude about self-treatment of varicose veins, many people try to self-treat? Including. folk medicine, nutritional supplements…
- Related to this question is another misconception among people, namely that the problem of varicose veins can be solved with magic creams and pills. Unfortunately, the various types of pills, ointments and nutritional supplements may only have a relieving effect, but there is absolutely no way to definitively cure already pronounced varicose veins with them. That is why I recommend that people consult a vascular specialist-angiologist or a vascular surgeon and not resort to self-medication. Because untimely and incorrect treatment can lead to unpleasant complications in the patient's condition.
What complications can it lead to?
- The most common complication is thrombophlebitis, which, if not treated adequately and in time, can be complicated by deep vein thrombosis. It, in turn, can lead to the most serious and life-threatening complication - the so-called pulmonary embolism. The other complications are related to the chronic changes on the skin and legs - hyperpigmentation, lipodermatosclerosis, as well as the opening of chronic venous wounds that are difficult to treat. It is because of the possible complications listed above that I recommend people suffering from chronic venous disease to take measures in a timely manner and not to delay solving their problem.
What is the prevention of varicose veins?
- The main recommendations related to prevention are avoiding immobilization and regular physical activities. Swimming, cycling and walking are very suitable sports. High temperatures should also be avoided. That is why it is advisable not to overdo it with visiting saunas and steam baths, as well as strongly heated rooms. Also avoid hormonal contraceptives, irrational eating, smoking, uncomfortable clothes and shoes. Regarding specific recommendations, I want to say that there is a certain set of simple and practical exercises that can be applied even in the office. A very simple exercise to perform, for example, is raising the feet on toes - at least 20-30 repetitions. It is good to do every hour, especially by people who work long hours at a desk and do not move actively during the working day. Another useful tip is to elevate your legs in the evening when you are in front of the TV or reading. It is useful when you bathe to pour lukewarm water over your feet at the end. People prone to developing varicose veins should wear elastic stockings and use cooling creams and venotonic medications. But these are all measures that have a relieving effect, so I will note again that it is important to consult a specialist if you already have varicose veins. Because exercise, pills, nutritional supplements, creams and compression stockings alone will not solve your problem.