Evaluation of varicose veins: what do the clinical signs and symptoms reveal about the underlying disease and need for intervention?

Abstract

Varicose veins and associated venous insufficiency are among the most common vascular conditions requiring specialist evaluation and treatment. Over 80% of people studied in a population based evaluation were found to have visible evidence of venous disease. In this article, the epidemiology of venous disease will be reviewed with specific attention to the common symptom patterns displayed by patients with superficial venous disease. Based on physical examination, the clinician can determine the likely sites of venous insufficiency and efficiently direct use of various diagnostic modalities, such as duplex ultrasound. The importance of the CEAP clinical classification will be discussed as a guide to choosing therapy from the multitude of available options for patients with venous insufficiency.