Varicose veins and the vascular surgeon: From nuisance to challenge

The Symptoms of Varicose Veins: Difficult to Determine and Difficult to Study

“…In a reference list of 297 papers accompanying a recent major review of varicose veins and their treatment, two references to the Edinburgh Vein Study were the only ones which addressed symptoms; 5,7,8 a description of symptoms occupies just half a page in a 567 page standard textbook on varicose veins; 6 and influential articles about how varicose veins should be dealt with fail to mention symptoms at all as part of the assessment of patients. 9 Compared with the volume of literature and the money spent on investigation and treatment of varicose veins, the dearth of good data on symptoms seems incredible and this was the main stimulus for the present study.…”

Flush saphenofemoral ligation and multiple stab phlebectomy preserve a useful greater saphenous vein four years after surgery

“…This greater understanding should, through logical application of such knowledge, lead to improved results. 14 The GSV remains the conduit of choice for infrainguinal bypass below the knee and after the internal mammary artery; the below-knee portion of the GSV is the preferred bypass graft in the coronary circulation) 5~16 Previous varicose vein surgery is not a contraindication to the use of residual vein for bypass grafting in the aortocoronary segment) 7 The GSV runs superficially and is exposed to high intraluminal pressures caused by gravitational forces, resulting in a strong, thick, muscular wall, features that make it suitable for use as a vascular graft in the arterial system. 18 These same properties may explain why the GSV itself is frequently not varicose.…”

Randomised clinical trial, observational study and assessment of cost-effectiveness of the treatment of varicose veins (REACTIV trial)

“…Surgeons have become increasingly specialised and varicose veins are dealt with largely by vascular surgeons, who have a greater degree of specialist knowledge and interest in their management. 21…”