Raktamokshana & Siravyadha in Varicosity: Hemodynamic and Symptomatic Outcomes With Comparative Evaluation of Sclerotherapy and Ayurvedic Management

Varicose veins are a chronic venous disorder characterized by dilated, tortuous superficial veins associated with venous hypertension, valvular incompetence, and impaired hemodynamics. Conventional management includes compression therapy, sclerotherapy, and surgical interventions, with sclerotherapy being widely utilized for symptomatic relief and cosmetic improvement. In Ayurveda, varicosity can be correlated with Siragata Vata and Raktadushti, where Raktamokshana (therapeutic bloodletting), particularly Siravyadha, is indicated as a primary intervention. Additionally, Shamana therapies and Basti Karma aim to correct underlying Vata imbalance and systemic pathology. This review critically evaluates the role of Raktamokshana and Siravyadha in improving hemodynamic parameters and clinical symptoms in varicose veins, and compares these approaches with modern sclerotherapy. A structured literature review was conducted using classical Ayurvedic texts and modern databases including PubMed, Scopus, and Web of Science. Evidence suggests that sclerotherapy provides rapid obliteration of affected veins, improving venous reflux and symptoms, whereas Raktamokshana may reduce venous congestion, local inflammation, and pain through decompression and detoxification mechanisms. Ayurvedic Shamana and Basti protocols offer systemic correction and may reduce recurrence. However, evidence for Ayurvedic interventions is limited by small sample sizes and lack of standardized methodologies. Integrative approaches combining modern and Ayurvedic strategies may enhance long-term outcomes. Further well-designed clinical trials are required to validate efficacy and safety.