Version June 2024
The algorithm describes the approach to managing superficial venous insufficiency associated with edema and dilated or varicose veins (CEAP 1 to 3). Superficial venous insufficiency can affect the superficial axial veins, which includes the GSV, SSV, and AASV, as well as nonaxial veins (ie, intersaphenous veins, truncal veins). Treating the axial veins may be sufficient to relieve symptoms and improve appearance and is performed before treating visible nonaxial veins.
Refer to UpToDate topics on the management of chronic venous disease for additional details on our approach to treatment and the overall efficacy of these treatments.VLU: venous leg ulcer; CEAP: Clinical-Etiology-Anatomy-Pathophysiology; GSV: great saphenous vein; SSV: small saphenous vein; AASV: anterior accessory saphenous vein; MOCA: mechanochemical ablation; CAC: cyanoacrylate adhesive closure.
* Axial venous reflux is defined as retrograde flow ≥0.5 seconds duration in the GSV, SSV, or AASV.
¶ Conservative care includes limb elevation, compression hosiery, limb exercises, and lifestyle modification (eg, avoidance of prolonged standing/sitting).
Δ Most ablation techniques can be used at any site; however, success rates and the nature and frequency of complications differ for various thermal and nonthermal ablation methods.
◊ Thermal ablation includes radiofrequency ablation and endovenous laser ablation. Requires an adequate length of vein.
§ Nonthermal ablation includes sclerotherapy (liquid, foam), MOCA, and CAC.
¥ While thermal or nonthermal options are preferred, if these are not an option, surgical ablation such as open ligation, division, stripping can be performed.
‡ Either at the completion of the ablation procedure, or at the time of follow-up.
† Evaluate for recanalization, which is more common following nonthermal ablation methods, particularly sclerotherapy.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
