Publication:

Comparative clinical study of siravedhana using 24G needle versus endovenous laser ablation in the management of lower limb varicose veins

Background Varicose veins are typical symptoms of chronic venous insufficiency, and they are linked to pain, edema, skin changes, and functional loss. This disorder is very similar to siraj granthi in Ayurveda and results from the vitiation of the doshas rakta and pitta. Such disorders are traditionally treated with siravedhana, which is an Ayurvedic process of bloodletting, whereas modern popular treatment is EVLA. The purpose of the study was to compare the clinical effectiveness and safety of siravedhana with a 24G needle and EVLA in the treatment of lower limb varicose veins.

Methods The clinical study was an open-label, randomised, double-arm study conducted in patients diagnosed with lower-limb varicose veins. The 24G needle was used to administer the siravedhana to group A, and EVLA was performed on group B. Clinical observation was conducted based on CEAP classification and Doppler ultrasonography. Patient follow-ups were conducted 15 days after discharge.

Results The two modalities of treatment led to major enhancement in the symptoms like pain, heaviness and edema. Siravedhana was effective for low-complexity disease in the early stages at a lower cost, whereas EVLA responded more quickly at advanced stages.

Conclusions Siravedhana is an inexpensive and safe option for early-stage varicose veins, whereas EVLA is preferable for advanced disease. An integrative approach can be optimal for the patient.