The Treatment of Primary Varicose Veins

Anatomy and Pathophysiology of Varicose Veins

“…Post‐partum thrombophlebitis is the most common cause of the postphlebitic syndrome 56 . In late pregnancy, the blood volume is increased, the uterus impedes venous return, and increases in hormonal levels produce an increased distensibility of veins with resulting valvular incompetence.…”

“…In addition, multiple factors present at childbirth appear to predispose this physiologic milieu to the development of thrombophlebitis. Therefore, graduated elastic support hosiery should be worn before, during, and immediately following labor in a woman with varicose veins 56 …”

Compression in the Treatment of Leg Telangiectasia: Theoretical Considerations

“…Therefore, sclerosing solutions of lesser strength may be utilized successfully. Second, compressing the treated vessel will decrease the extent of thrombus formation, which inevitably occurs with the use of all sclerosing agents, 17–19 thereby decreasing the risk for recanalization of the treated vessel 15,20,21 . Third, a decrease in the extent of thrombus formation may also decrease the incidence of postsclerosis pigmentation 5,10,22 .…”

“…However, a 3‐day time period for compression of leg telangiectasias is recommended based on the empirical report of Ouvry and Davy, 21 who advised a minimum of 3 days to limit the development of peripheral inflammation and intravascular thrombosis. Without supporting information, Harridge 18 recommends a 1‐week period of compression for spider veins with a local pressure band of elastic adhesive only.…”