Updates in the Management of primary varicose veins of the lower limbs

Abstract

The prevalence of varicose have been may reach up to 60% in the adult population, with2% have more advanced chronic venous disease per year, including skin changes and healed or active venous ulcers. Varicose veins have long been considered a cosmetic problem, however, they are frequently the cause of discomfort, pain, loss of working days, disability, and deterioration of health-related quality of life. Severe chronic venous disease may also lead to loss of limb or loss of life. Evaluation of varicose veins has greatly progressed with the widespread availability of duplex ultrasonography. The treatment of varicose veins has also undergone dramatic changes with the introduction of percutaneous endovenous ablation techniques, including endovenous laser therapy (EVLA), radiofrequency ablation (RFA), and liquid or foam sclerotherapy. Open surgical treatment with stripping of the varicose veins performed under general anesthesia, with the associated pain and potential for wound complications, has been largely replaced by percutaneous office-based procedures that can be performed under local or tumescent anesthesia with similar early and midterm results but with less discomfort to the patient, , and earlier return to work.

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