Treatment of varicose veins

Abstract

T HE injection treatment of varicose veins has enjoyed a wave of popuIarity in the past few years and as a resuIt surgica1 procedures have faIIen into discard. This is IargeIy due to the fact that the sclerosing soIutions have become more efficient, the injection treatment seemed to be Iess formidabIe than surgery, and hospitalization couId be avoided. The test of time has shown that permanent resuIts were not being obtained and more radica1 measures than the injection of scIerosing soIutions are required for permanent reIief. The treatment of varicose veins by Iigation and injection is known to have been performed over thirty years ago. This form of therapy, however, was not emphasized until recentIy and is now recognized as the most reIiabIe method of obtaining permanent cures.1,2,3,4 There are some cases which respond to injection treatment aIone, but these are in the minority. Varicosities generaIIy are stiI1 being under-treated. Modern treatment should be more thorough treatment, with fewer recurrences. To treat successfuIIy varicose veins and their compIications the extent of the underIying disease must be recognized. No form of therapy shouId be instituted until the efficiency of the vaIves of the saphenous and communicating veins and the patency of the deep circulation is known and arteria1 disease of the Iower extremities ruIed out. These factors are determined as folIows : A. Tests to Determine the Valvular Competence of the Sapbenous Veins and Its Communicating Branches with the Deep Circulation. I. Schwartz test :5 The flat portions of the fingers of one hand are pIaced aIong the usua1 course of the saphenous vein in the thigh, and the vein is sharpIy tapped on one of its varicosities CLAYTON SHIRLEY, M.D., F.A.C.S.