Treatment of varicose veins may be indicated to relieve discomfort, to prevent or ameliorate complications, or for cosmetic reasons.
Methods:
- conservative
- interventional treatment
About one-third of cases can be managed by offering common sense advice as to how to take care for their legs (1)
Assessment and treatment in a vascular service
- assessment
- use duplex ultrasound to confirm the diagnosis of varicose veins and the extent of truncal reflux*, and to plan treatment for people with suspected primary or recurrent varicose veins
- interventional treatment
- for people with confirmed varicose veins and truncal reflux:
- offer endothermal ablation and endovenous laser treatment of the long saphenous vein
- if endothermal ablation is unsuitable, offer ultrasound-guided foam sclerotherapy
- if ultrasound-guided foam sclerotherapy is unsuitable, offer surgery
- if incompetent varicose tributaries are to be treated, consider treating them at the same time
- if offering compression bandaging or hosiery for use after interventional treatment, do not use for more than 7 days
- non-interventional treatment
- Do not offer compression hosiery to treat varicose veins unless interventional treatment is unsuitable
*the extent of truncal reflux is the amount of backflow of blood through a main superficial vein
Notes:
- sclerotherapy - permanent obliteration of varices
- open operation - removal of varices with ligation of incompetent perforaters
Reference: