AVF/AVLS/SVS Management of Varicose Veins of the Lower Extremities - Duplex Scanning and Treatment of Superficial Truncal Reflux Guideline Summary - Guideline Central
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Document Overview

Management of Varicose Veins of the Lower Extremities

Part 1 - Duplex Scanning and Treatment of Superficial Truncal Reflux

American Vein & Lymphatic Society

American Venous Forum

Society for Vascular Surgery


Publication Date: Oct 11, 2022

Page Last Updated: May 5, 2026


Recommendation Grading


Document Overview

Document Title
Management of Varicose Veins of the Lower Extremities - Duplex Scanning and Treatment of Superficial Truncal Reflux
Authoring Societies

American Vein & Lymphatic Society

American Venous Forum

Society for Vascular Surgery

Endorsing Society

Society for Vascular Medicine

Document Publication Date
Oct 11, 2022
Page Last Reviewed/Updated
May 5, 2026
Document Type
Guideline
Country of Publication
United States
Full Text Freely Available
Yes
Full Text Guideline
www.jvsvenous.org/article/S2213-333X(22)00417-6/fulltext
Source Citation

Gloviczki P, Lawrence PF, Wasan SM, Meissner MH, Almeida J, Brown KR, Bush RL, Di Iorio M, Fish J, Fukaya E, Gloviczki ML, Hingorani A, Jayaraj A, Kolluri R, Murad MH, Obi AT, Ozsvath KJ, Singh MJ, Vayuvegula S, Welch HJ. The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part I. Duplex Scanning and Treatment of Superficial Truncal Reflux: Endorsed by the Society for Vascular Medicine and the International Union of Phlebology. J Vasc Surg Venous Lymphat Disord. 2022 Oct 12:S2213-333X(22)00417-6. doi: 10.1016/j.jvsv.2022.09.004. Epub ahead of print. PMID: 36326210.


Document Scope, Criteria, and Use Cases

Document Objectives

The Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society collaborated to update the 2011 Society for Vascular Surgery/American Venous Forum clinical practice guidelines and provide new evidence-based recommendations on critical issues affecting the care of patients with varicose veins. Each recommendation is based on a recent, independent systematic review and meta-analysis of the diagnostic tests and treatments options for patients with lower extremity varicose veins. Part I of the guidelines includes evidence-based recommendations for the evaluation of patients with CEAP (Clinical Class, Etiology, Anatomy, Pathology) class 2 varicose vein using duplex ultrasound scanning and other diagnostic tests, open surgical treatment (ligation and stripping) vs endovenous ablation techniques, thermal vs nonthermal ablation of the superficial truncal veins, and management of incompetent perforating veins in CEAP class 2 disease. We have also made recommendations on the concomitant vs staged treatment of varicose tributaries using phlebectomy or liquid or foam sclerotherapy (with physician-compounded foam or commercially prepared polidocanol endovenous microfoam) for patients undergoing ablation of incompetent superficial truncal veins.

Scope
Assessment and Screening, Diagnosis, Management, Treatment
Diseases/Conditions (MeSH)

D014648 - Varicose Veins

D014648 - Varicose Veins

Keywords
duplex scanning, superficial truncal reflux, varicose veins
Inclusion Criteria
Male, Female, Adult, Older Adult
Health Care Settings
Ambulatory, Operating and Recovery Room, Outpatient
Intended Users
Nurse, Nurse Practitioner, Physician, Physician Assistant
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