The Treatment of Varicose Veins

Abstract

Varicose veins are a common problem and cause disfigurement, disability and impairment in the quality of life (QoL). Over 40,000 operations are performed each year for varicose veins within the NHS in England and Wales. Conservative methods like compression bandaging for ulceration can also be expensive. Varicose veins are, therefore, of significant clinical and economic importance to the health service and also have a major socio-economic impact on society. The advent of endovenous ablation techniques has expanded the surgical options for patients requiring treatment. Materials and MethodsRelevant studies were identified via the MEDLINE, PREMEDLINE, EMBASE, PubMed, Cochrane Library and Science Citation Index using Boolean search terms from their commencement to 2005. Further studies were obtained from references, reviews, specialty journals, trial registries and the internet and by hand-searching. Abstracts were searched for studies reporting safety, efficacy, technique and outcomes with emphasis on comparative studies and large case series. The authors concentrated on evidence published in the last 10 years to achieve a balance between comprehensiveness and precision. Non-English articles were excluded unless a translation could be obtained. Conference abstracts and unpublished reports were excluded. ResultsDefinitive treatment of varicose veins aimed at abolishing sources of venous reflux and removing long refluxing segments and varicose reservoirs can be achieved by conventional surgery or by endovenous ablation techniques. Transilluminated powered phlebectomy and subfascial endoscopic perforator surgery are less commonly employed.The main outcome in the selected studies is the abolition of saphenous vein reflux. However, there is wide variation in the reporting of outcomes between studies. Elimination of varicosities, recanalisation after endovenous ablation, recurrence of reflux, re-appearance of varicose veins, symptomatic improvement and re-treatment rates are not reported in all studies. Varicosities evident at follow-up are not clearly differentiated into residual, recurrent or newly incompetent veins. Some studies are affected by significant follow-up loss.

www.Accurate Information for Varicose Vein patients.com?

“…[1][2][3] Although endovenous techniques are popular with both patients and physicians due to perceived advantages, evidence is lacking to suggest that any single technique is superior.T herefore, informing patients effectively to guide their decision making is more important than ever.…”

An Alternative Treatment for Varicose Veins: Ligation Plus Foam Sclerotherapy

“…In addition to these surgical techniques, conservative methods such as compression bandaging for ulceration are available but can be expensive. Thus, varicose veins, which affect 20% to 40% of western populations, have a significant clinical and economic effect on society 1–3 …”

Postoperative prophylaxis of venous thromboembolism (VTE) in patients undergoing high ligation and stripping of the great saphenous vein (GSV)

“…11 Although various new techniques have been developed in recent years, conventional surgery is still the most widely used in China and Third World countries today. 12,13 This procedure, however, may be complicated by DVT or PE as a morbid and possible mortal complication of this procedure. 5 Neither the incidence of postoperative VTE following varicose vein surgery nor the appropriate chemoprophylaxis strategy have been adequately established in large patient population studies.…”