Varicose veins are a common condition that affects up to 30% of adults, with a higher prevalence in women. This condition can cause discomfort, pain, and even more severe complications such as bleeding or venous ulcers. Endovenous thermal ablation (EVTA) is considered the first-line treatment for varicose veins and has been shown to be an effective and minimally invasive technique to treat this condition.
Despite the success of EVTA, there is still much to learn about the effects of the treatment on the vein wall. In-vitro models using explanted human great saphenous veins (GSV) have been used to study the impact of EVTA, but the addition of anticoagulated blood to simulate physiological flow has been questioned. The study by Prof. Mark Steven Whiteley and Tim J Fernandez-Hart aimed to investigate the presence of blood during EVTA treatment in clinical situations.
The study’s findings were surprising and could have significant implications for future research on the topic. The researchers found no significant evidence of blood within the GSV during treatment. When patients were in the 10° head-down position with the endovenous laser device in position and tumescence around the vein, 10 out of 11 GSVs showed no lumen at all. The remaining GSV showed a minor “out-pouching” on one side of the device at one level, which did not communicate with any lumen above or below and showed no flow.
These results suggest caution in using models that add anticoagulated blood to the vein lumen before treatment, as it may not accurately reflect the clinical situation. The presence of blood could be a confounding variable, reducing the energy reaching the vein wall during EVTA treatment. Understanding this could lead to more accurate modeling and a better understanding of the effects of EVTA on the vein wall.
The study’s results are promising and could improve outcomes for patients undergoing EVTA treatment. The findings provide a more accurate understanding of the clinical situation, which could improve the modeling of EVTA treatment and, ultimately, improve patient outcomes. Further research is needed to confirm the results of this study and to investigate the implications of these findings in more detail. Nonetheless, this study represents a crucial step forward in understanding the effects of EVTA on the vein wall, providing insights that could lead to improved patient outcomes in the future.
