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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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:


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