Management of varicose veins and venous insufficiency

JAMA. 2012 Dec 26;308(24):2612-21. doi: 10.1001/jama.2012.111352.

Abstract

Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

Publication types

  • Clinical Conference
  • Review

MeSH terms

  • Aged
  • Decision Making
  • Female
  • Humans
  • Recurrence
  • Risk Factors
  • Sclerotherapy
  • Stockings, Compression
  • Varicose Veins* / epidemiology
  • Varicose Veins* / pathology
  • Varicose Veins* / therapy
  • Venous Insufficiency* / epidemiology
  • Venous Insufficiency* / pathology
  • Venous Insufficiency* / therapy