Lower Extremity Varicose Veins

Publication Date: August 28, 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

...agnosi...

...ation of Patients With Varicose Vein...

...ation and grading of clinical severity...

Good Practice Statement...

...1.1.We recommend the use of the 2020 updated Cli...

....We recommend the use of the revised Ve...

....–1.5. Doppler ultrasound scanning (DUS)

...ommendation...

1.2.1.For patients with chronic venous diseas...

...mentation Remarks...

....Reflux is defined as a minimum value >500 ms of r...

...xial reflux of the GSV is defined as unint...

...efinition of “pathologic” perforating veins i...

Good Practice Statem...

...ommend that evaluation of reflux wi...

...ecommend that for evaluation of ref...

...mend that a complete DUS examination for ve...

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

...ommend that a complete DUS examina...

...nsensus Statemen...

...n asymptomatic patients with telangie...

1.5.2.In symptomatic CEAP Class C1 patients...

....5.3.In symptomatic patients with varicose veins...

....In symptomatic patients with varicose v...

....5.5.In patients with medial thigh or vulvar var...


Treatment

...eatment...

...mpression Therapy...

...1. Compression therapy vs. in...

...commendation...

2.1.1.For patients with symptomatic varicose vei...

...ients with symptomatic varicose veins and axia...

...patients with symptomatic varicose vei...

...patients with symptomatic varicose veins...

...ion therapy after intervention...

....2.1.In patients undergoing thermal ablatio...


3. Pharmacological Treatment

...mendations...

...In symptomatic patients with varicose...

...n symptomatic patients with varicose ve...


...  Interventions for Superficial Truncal Re...

4.1. Endovenous ablation vs. high ligation an...

...ecommendati...

....1.For patients with symptomatic varico...

...ients with symptomatic varicose veins an...

...nts with symptomatic varicose veins and a...

...tients with symptomatic varicose veins an...

...ents with symptomatic varicose veins and axia...

....1.6.For patients with symptomatic...

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

....1.8.For patients with symptomatic var...

.... Thermal vs. non-thermal ablation of su...

...ommendations...

...ients with symptomatic axial reflux of...

....For patients with symptomatic axial...

....3.For patients with symptomatic axial r...


...Factors Affecting Choice of Superficial Trunc...

...ommendation...

...mptomatic patients with C2 disease we suggest ag...

...ensus Statements...

...mptomatic patients with C2 disease, pr...

....2.Interventions to treat varicose veins can be pe...

...ients with symptomatic C2 disease, isolated SFJ i...

...ts with symptomatic C2 disease, ablation of the i...

...n patients with reflux in the below-k...

...2.6.In patients with an epifascial...

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

...nce of superficial thrombophlebitis has been repo...

....2.9.In patients with uncomplicated C2 di...


6. Interventions to Pres...

...ecommendati...

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

....For patients with symptomatic varicose veins,...


...reatment of Venous Tributaries...

...iectasias and reticular veins...

...mmendations...

...ients with symptomatic telangiectasias and...

...2.For patients with symptomatic telangiectasias o...

....2. Varicose tributa...

...mmendation...

....2.1.For treatment of symptomatic varicose...

...treatment of symptomatic varicose tributaries...

...ensus Statemen...

....3.For patients with symptomatic var...

...ere is no clinical evidence that foam...

7.2.5.There is currently no clinica...


...nt of Varicose Tributaries Concomittant or St...

Recommendati...

...ents with symptomatic reflux in the...

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

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

...nts with symptomatic reflux in the AAGSV or...

...cal Practice Statement...

...s with symptomatic reflux in the major supe...


...ent of Recurrent Varicosities...

...sensus Statement...

...nts with symptomatic recurrent varic...

....For patients with symptomatic recurrent varicosi...

...r patients with symptomatic recurrent varic...

...r patients with symptomatic recurrent...

9.1.5.For patients with residual or recurrent...


10. Ablation of Incompetent Perforati...

...ecommendati...

...0.1.1.For patients with varicose veins (CEAP class...

...ients with varicose veins (CEAP class C2)...

Consensus Statemen...

...ts with incompetent pathologic perforators associa...


...t of Ablation-related Thrombus Extension (ARTE) An...

...Post-procedure DUS...

...commendation

...In an average-risk patient who is asymptomatic f...

...nsus Statements...

...1.1.2.In an average-risk patient who is asymptomat...

11.1.3.In a high-risk patient who is asympto...

...mmendation...

11.1.4.In patients who are symptomatic following t...

...Pharmacological thromboprophyla...

...mmendation...

...risk patients undergoing endovenous ablat...

...sensus Statem...

...2.2.For patients undergoing endovenous...

...of varicose vein procedure relate...

...mendationsb...

...3.1.For patients with acute isolated di...

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

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

...or patients with symptomatic ARTE after endovenou...

...dorsed the recommendations of Stevens SM, Woller...

...sus Statements...

...patients with asymptomatic ARTE III...

...ents who receive anticoagulation for ARTE...


...t of Superficial Vein Thrombosis (SVT)...

Recommendation 12 addresses the manag...

...ecommendation

...2.1.1.For patients with SVT of the m...

...sus Statement...

...1.2For patients with SVT of the main saphenous tru...

...mmendations

...tients with SVT of the main saphenous trunks we...

...For selected patients with isolated throm...

Consensus Sta...

...nts with saphenous thrombophlebitis,...


...t of Bleeding Varicose Veins...

...sensus Statement...

...tients presenting with acute bleeding from var...

....For patients with bleeding due to varicose veins,...

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

...s with varicose veins or venous ulcerations...


...Management of Superficial Vein Aneu...

...onsensus Statements

14.1.For patients with superficial trunca...

...r patients with an asymptomatic superfic...

...4.3.Patients with symptomatic, thrombosed...


...e 1. Revised VCSSHaving trouble viewing table? Ex...


...-active Drugs for CVDaHaving trouble view...


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


...ure 2. Anatomy of SSV and Its Tribu...


.... Perforating Veins of the LegPTV, p...