Lower Extremity Varicose Veins

Publication Date: August 27, 2023

Key Points

Key Points

  • Varicose veins of the lower extremities are among the most frequent medical conditions affecting millions of people worldwide.
  • Chronic venous disease (CVD) may cause minimal symptoms, but varicose veins may often also be the source of discomfort, pain, swelling, thrombosis, bleeding and ulcerations, causing disability and a negative impact on physical, psychological, and social functioning components of quality of life.
  • Patients with chronic venous insufficiency (CVI) may progress to phlebolymphedema, skin changes with chronic inflammation, and venous leg ulcerations.

Diagnosis

...iagnos...

...Evaluation of Patients With Varicose...

1.1. Classification and grading of c...

...actice Statements...

....We recommend the use of the 2020 updated Cl...

...recommend the use of the revised Ven...

...1.5. Doppler ultrasound scanning (DUS)

...mmendation...

...ts with chronic venous disease of the lower extre...

...entation Remarks...

...s defined as a minimum value >500 ms of revers...

...lux of the GSV is defined as uninterrupted ret...

...3.A definition of “pathologic” perforating ve...

...Practice Statements

....1.We recommend that evaluation of reflux...

...4.2.We recommend that for evaluation of r...

....We recommend that a complete DUS examination...

...4.We recommend that a complete DUS exam...

...mend that a complete DUS examination for venous re...

...ensus Statements...

1.5.1.In asymptomatic patients with...

...ptomatic CEAP Class C1 patients with bl...

...matic patients with varicose veins (CEAP C...

...symptomatic patients with varicose...

....In patients with medial thigh or vulva...


Treatment

...atment...

...ompression Therap...

.... Compression therapy vs. intervention...

...commendatio...

...patients with symptomatic varicose veins a...

...1.2.For patients with symptomatic varicose v...

...tients with symptomatic varicose v...

...nts with symptomatic varicose veins who are...

.... Compression therapy after intervention...

...patients undergoing thermal ablation for s...


...armacological Treatment

...ecommendations...

...atic patients with varicose veins who are not cand...

3.2.In symptomatic patients with v...


...rventions for Superficial Truncal Reflux...

...Endovenous ablation vs. high ligat...

...ecommendati...

...1.For patients with symptomatic varic...

...r patients with symptomatic varicose veins a...

...or patients with symptomatic varicose veins and ax...

....For patients with symptomatic varicose veins and...

...or patients with symptomatic varicose veins a...

...atients with symptomatic varicose ve...

...1.7.For patients with symptomatic va...

...patients with symptomatic varicose veins an...

.... non-thermal ablation of superfic...

...commendations...

...1.For patients with symptomatic axial r...

4.2.2.For patients with symptomatic...

....2.3.For patients with symptomatic ax...


...ffecting Choice of Superficial Truncal Ablati...

...ommendation

...symptomatic patients with C2 disease...

Consensus State...

5.2.1.In asymptomatic patients with C2 di...

...tions to treat varicose veins can be perfo...

...nts with symptomatic C2 disease, isola...

...nts with symptomatic C2 disease, ablation of...

...s with reflux in the below-knee GSV,...

...ents with an epifascial or superfi...

...2.7.For patients with large (>10 mm), non-aneurysm...

...e incidence of superficial thrombophlebit...

5.2.9.In patients with uncomplicated C2 disea...


...ions to Preserve the GSV...

...ecommendations

...For patients with the early stages of symp...

...ts with symptomatic varicose veins, we suggest...


...eatment of Venous Tributaries...

...1. Telangiectasias and reticular v...

Recommendati...

...or patients with symptomatic telangiectasias a...

7.1.2.For patients with symptomati...

7.2. Varicose tributa...

...mmendation...

....2.1.For treatment of symptomatic varicos...

....2.2.For treatment of symptomatic var...

...sus Statements

...tients with symptomatic varicose tributaries, trea...

...is no clinical evidence that foam sclerother...

...here is currently no clinical study of...


...ment of Varicose Tributaries Concomittant...

...ommendatio...

...nts with symptomatic reflux in the...

...atients with symptomatic reflux in the...

...1.3.For patients with symptomatic reflux...

....4.For patients with symptomatic reflux in the AAG...

...nical Practice Statement...

....For patients with symptomatic reflux in the...


...Management of Recurrent Varicosities

Consensus State...

...For patients with symptomatic recurr...

....1.2.For patients with symptomatic recurrent varic...

....1.3.For patients with symptomatic recurrent v...

...1.4.For patients with symptomatic recurrent v...

9.1.5.For patients with residual or recurr...


...f Incompetent Perforating Vein...

...mendations...

...r patients with varicose veins (CEAP...

...0.1.2.For patients with varicose ve...

...sensus Statement...

....2.For patients with incompetent pathologic pe...


...ement of Ablation-related Thrombus Extension (...

....1. Post-procedure...

...commendation...

....1.1.In an average-risk patient who i...

...nsensus Statemen...

....In an average-risk patient who is asymptomati...

....1.3.In a high-risk patient who is asymptomat...

...mmendation...

....1.4.In patients who are symptomatic followin...

.... Pharmacological thromboprophylaxis...

...commendati...

11.2.1.For high-risk patients undergoi...

...nsensus Statem...

....For patients undergoing endovenous ablati...

...nt of varicose vein procedure related...

...mendationsb...

...1.3.1.For patients with acute isolated...

....2.For patients with isolated distal DVT af...

...3.3.For patients with acute proxim...

...nts with symptomatic ARTE after endoveno...

b We endorsed the recommendations of Stevens S...

...nsus Statements...

...1.4.1.For patients with asymptomat...

...ents who receive anticoagulation for AR...


12. Management of Superficial Vein Thrombosis (SVT...

...12 addresses the management of SVT in...

Recommenda...

...atients with SVT of the main saphenous t...

...ensus Stateme...

...1.2For patients with SVT of the main sap...

...mendations...

...atients with SVT of the main saphenous trun...

...selected patients with isolated thrombosi...

...sensus Statem...

...tients with saphenous thrombophlebitis, ab...


.... Management of Bleeding Varicose V...

Consensus State...

...ents presenting with acute bleeding from var...

...or patients with bleeding due to v...

....3.For patients who presented with b...

...nts with varicose veins or venous ulcerations sho...


...nt of Superficial Vein Aneurysms...

...ensus Statements

....1.For patients with superficial t...

...s with an asymptomatic superficial truncal ve...

...ts with symptomatic, thrombosed or large (>3...


...1. Revised VCSSHaving trouble view...


...Veno-active Drugs for CVDaHaving trouble...


...atomy of GSV and Its Tributariesa., artery; n....


...y of SSV and Its Tributariesn., nerve...


.... Perforating Veins of the LegPTV, posterior tibi...