Varicose Vein Treatment and Its Success Rate
,
Abstract
A B S T R A C T Background: Chronic venous illness is one of the major developing illnesses across the world. Varicose vein leads to major negative consequences, including missed work, pain, discomfort, and a deterioration in quality of life. Methods: Varicose veins affect people’s quality of life and range in incidence from 10% to 30% worldwide Varicose vein treatment options are taken based on a number of factors, including patient preferences, postoperative risk, cost, and the degree of the venous insufficiency.). Varicose vein patients who are asymptomatic are initially treated conservatively with medications, compression therapy, and lifestyle changes. Patients who are symptomatic, on the other hand, are advised to look at surgical options such as radiofrequency ablation(RFA), endovenous laser ablation (EVLA), high ligation and stripping (HL/S) of the incompetent great saphenous vein (GSV), Cure conservatrice et Hemodynamique de Insufficience veineuse en Ambulatoire (CHIVA) , mechanochemical ablation (MOCA) , cyanoacrylate embolization (CAE),etc. Results: Each treatment is effective in the treatment of each type and each stage of varicose veins and has its pros and cons. This article analysis the varicose vein treatments and discusses the safety, efficacy and success rate of each treatments.
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[3] Piazza G. (2014). Varicose veins. Circulation, 130(7), 582–587. https://doi.org/10.1161/CIRCULATIONAHA.113.008331
[4] Raetz J, Wilson M, Collins K. Varicose Veins: Diagnosis and Treatment. Am Fam Physician. 2019 Jun 1;99(11):682-688.
[5] Eklof B, Perrin M, Delis KT, Rutherford RB, Gloviczki P; American Venous Forum; European Venous Forum; International Union of Phlebology; American College of Phlebology; International Union of Angiology. Updated terminology of chronic venous disorders: the VEIN-TERM transatlantic interdisciplinary consensus document. J Vasc Surg. 2009 Feb;49(2):498-501.
[6] Korn P, Patel ST, Heller JA, Deitch JS, Krishnasastry KV, Bush HL, Kent KC. Why insurers should reimburse for compression stockings in patients with chronic venous stasis. J Vasc Surg. 2002 May;35(5):950-7.
[7] Chwała M, Szczeklik W, Szczeklik M, Aleksiejew-Kleszczyński T, Jagielska-Chwała M. Varicose veins of lower extremities, hemodynamics and treatment methods. Adv Clin Exp Med. 2015 Jan-Feb;24(1):5-14.
[8] Prabha Shrestha, Robin Man Karmacharya, Sushil Dahal, Prasesh Dhakal, Niroj Bhandari, Sohail Bade, Patient literacy on varicose veins in cases presenting at university hospital of Nepal subjected for surgical management of varicose veins, Journal of Vascular Nursing,Volume 39, Issue 1, 2021,Pages 2-5,ISSN 1062-0303.
[9] Poredos P, Spirkoska A, Rucigaj T, Fareed J, Jezovnik MK. Do blood constituents in varicose veins differ from the systemic blood constituents? Eur J Vasc Endovasc Surg. 2015;50(2):250–6.
[10] Medical Advisory Secretariat. Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis. Ont Health Technol Assess Ser. Epub 2011 Feb 1.2011;11(1):1-93.
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[15] Varicose veins: diagnosis and management Clinical guideline Published: 24 July 2013
[16] Brandon P. Kitchens Robert J. Snyder Cherison Cuffy, A Literature Review of Pharmacological Agents to Improve Venous Leg Ulcer Healing, July 2020 ISSN 1044-7946 Index Wounds 2020;32(7):195–207.
[17] Lim CS, Davies AH. Graduated compression stockings. CMAJ. 2014 Jul 8;186(10):E391-8.
[18] Palfreyman SJ, Michaels JA. A systematic review of compression hosiery for uncomplicated varicose veins. Phlebology. 2009;24 Suppl 1:13-33.
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[23] Colgan MP, Dormandy JA, Jones PW, Schraibman IG, Shanik DG, Young RA. Oxpentifylline treatment of venous ulcers of the leg. BMJ. 1990 Apr 14;300(6730):972-5.
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[25] Nelson EA. Venous leg ulcers. BMJ Clin Evid. 2011 Dec 21;2011:1902.
[26] Andreozzi GM. Effectiveness of mesoglycan in patients with previous deep venous thrombosis and chronic venous insufficiency. Minerva Cardioangiol. 2007 Dec;55(6):741-53.
[27] McGrath JA, Eady RA. Heparan sulphate proteoglycan and wound healing in skin. J Pathol. 1997;183(3):251–252. doi:10.1002/(SICI)1096-9896(199711)183:33.0.CO;2-H
[28] Jazz Pharmaceuticals Announces FDA Approval of Defitelio® (defibrotide sodium) for the Treatment of Hepatic Veno-Occlusive Disease (VOD) with Renal or Pulmonary Dysfunction Following Hematopoietic Stem-Cell Transplantation (HSCT),March 30, 2016
https://investor.jazzpharma.com/news-releases/news-release-details/jazz-pharmaceuticals-announces-fda-approval-defitelior
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[31] Katsenis K. Micronized purified flavonoid fraction (MPFF): a review of its pharmacological effects, therapeutic efficacy and benefits in the management of chronic venous insufficiency. Curr Vasc Pharmacol. 2005 Jan;3(1):1-9.
[32] Arosio E, Ferrari G, Santoro L, Gianese F, Coccheri S; Mesoglycan Venous Insufficiency Group. A placebo-controlled, double-blind study of mesoglycan in the treatment of chronic venous ulcers. Eur J Vasc Endovasc Surg. 2001 Oct;22(4):365-72.
[33] Tufano A, Arturo C, Cimino E, Di Minno MN, Di Capua M, Cerbone AM, Di Minno G. Mesoglycan: clinical evidences for use in vascular diseases. Int J Vasc Med. Epub 2010 Aug 31.2010;2010:390643.
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[35] Scondotto G, Aloisi D, Ferrari P, Martini L. Treatment of venous leg ulcers with sulodexide. Angiology. 1999 Nov;50(11):883-9.
[36] Raffetto JD, Marston WA. Venous ulcer: what is new? Plast Reconstr Surg. 2011 Jan;127 Suppl 1:279S-288S.
[37] Martinez-Zapata MJ, Vernooij RW, Uriona Tuma SM, Stein AT, Moreno RM, Vargas E, Capellà D, Bonfill Cosp X. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2016 Apr 6;4(4):CD003229.
[38] Whing J, Nandhra S, Nesbitt C, Stansby G. Interventions for great saphenous vein incompetence. Cochrane Database Syst Rev. 2021 Aug 11;8(8):CD005624.
[39] Medical Advisory Secretariat. Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis. Ont Health Technol Assess Ser. 2011;11(1):1-93. Epub 2011 Feb1.
[40] Lees TA, Beard JD, Ridler BM, Szymanska T. A survey of the current management of varicose veins by members of the Vascular Surgical Society. Annals of the Royal College of Surgeons of England. 1999 Nov;81(6):407.
[41] Sam RC, Silverman SH, Bradbury AW. Nerve injuries and varicose vein surgery. Eur J Vasc Endovasc Surg. 2004 Feb;27(2):113-20.
[42] Critchley G, Handa A, Maw A, Harvey A, Harvey MR, Corbett CR. Complications of varicose vein surgery. Ann R Coll Surg Engl. 1997 Mar;79(2):105-10.
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[44] Hoggan BL, Cameron AL, Maddern GJ. Systematic review of endovenous laser therapy versus surgery for the treatment of saphenous varicose veins. Annals of vascular surgery. 2009 Mar 1;23(2):277-87.
[45] Sadick NS. Advances in the treatment of varicose veins: ambulatory phlebectomy, foam sclerotherapy, endovascular laser, and radiofrequency closure. Adv Dermatol. 2006;22:139-56.
[46] Belramman A, Bootun R, Lane TRA, Davies AH. Foam sclerotherapy versus ambulatory phlebectomy for the treatment of varicose vein tributaries: study protocol for a randomised controlled trial. Trials. 2019 Jul 3;20(1):392.
[47] de Roos KP, Nieman FH, Neumann HA. Ambulatory phlebectomy versus compression sclerotherapy: results of a randomized controlled trial. Dermatol Surg. 2003 Mar;29(3):221-6.
[48] Franceschi C, Cappelli M, Ermini S, Gianesini S, Mendoza E, Passariello F, Zamboni P. CHIVA: hemodynamic concept, strategy and results. Int Angiol. 2016 Feb;35(1):8-30. Epub 2015 Jun 5.
[49] Faccini FP, Ermini S, Franceschi C. CHIVA to treat saphenous vein insufficiency in chronic venous disease: characteristics and results. J Vasc Bras. 2019 Jan 30;18:e20180099.
[50] Allegra C. Invasive treatment of varicose veins: a comparison of techniques. Acta Phlebol. 2018 Apr;19:1-2.
[51] Zamboni P, Cisno C, Marchetti F, Mazza P, Fogato L, Carandina S, De Palma M, Liboni A. Minimally invasive surgical management of primary venous ulcers vs. compression treatment: a randomized clinical trial. Eur J Vasc Endovasc Surg. 2003 Apr;25(4):313-8.
[52] ] Aremu MA, Mahendran B, Butcher W, Khan Z, Colgan MP, Moore DJ, Madhavan P, Shanik DG. Prospective randomized controlled trial: conventional versus powered phlebectomy. J Vasc Surg. 2004 Jan;39(1):88-94.
[53] de Zeeuw R, Wittens C, Loots M, Neumann M. Transilluminated powered phlebectomy accomplished by local tumescent anaesthesia in the treatment of tributary varicose veins: preliminary clinical results. Phlebology. 2007;22(2):90-4.
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[2] Heller, J. A., & Evans, N. S. (2015). Varicose veins. Vascular medicine (London, England), 20(1), 88–90. https://doi.org/10.1177/1358863X14566224
[3] Piazza G. (2014). Varicose veins. Circulation, 130(7), 582–587. https://doi.org/10.1161/CIRCULATIONAHA.113.008331
[4] Raetz J, Wilson M, Collins K. Varicose Veins: Diagnosis and Treatment. Am Fam Physician. 2019 Jun 1;99(11):682-688.
[5] Eklof B, Perrin M, Delis KT, Rutherford RB, Gloviczki P; American Venous Forum; European Venous Forum; International Union of Phlebology; American College of Phlebology; International Union of Angiology. Updated terminology of chronic venous disorders: the VEIN-TERM transatlantic interdisciplinary consensus document. J Vasc Surg. 2009 Feb;49(2):498-501.
[6] Korn P, Patel ST, Heller JA, Deitch JS, Krishnasastry KV, Bush HL, Kent KC. Why insurers should reimburse for compression stockings in patients with chronic venous stasis. J Vasc Surg. 2002 May;35(5):950-7.
[7] Chwała M, Szczeklik W, Szczeklik M, Aleksiejew-Kleszczyński T, Jagielska-Chwała M. Varicose veins of lower extremities, hemodynamics and treatment methods. Adv Clin Exp Med. 2015 Jan-Feb;24(1):5-14.
[8] Prabha Shrestha, Robin Man Karmacharya, Sushil Dahal, Prasesh Dhakal, Niroj Bhandari, Sohail Bade, Patient literacy on varicose veins in cases presenting at university hospital of Nepal subjected for surgical management of varicose veins, Journal of Vascular Nursing,Volume 39, Issue 1, 2021,Pages 2-5,ISSN 1062-0303.
[9] Poredos P, Spirkoska A, Rucigaj T, Fareed J, Jezovnik MK. Do blood constituents in varicose veins differ from the systemic blood constituents? Eur J Vasc Endovasc Surg. 2015;50(2):250–6.
[10] Medical Advisory Secretariat. Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis. Ont Health Technol Assess Ser. Epub 2011 Feb 1.2011;11(1):1-93.
[11] Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, Lohr JM, McLafferty RB, Meissner MH, Murad MH, Padberg FT, Pappas PJ, Passman MA, Raffetto JD, Vasquez MA, Wakefield TW; Society for Vascular Surgery; American Venous Forum. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011 May;53(5 Suppl):2S-48S.
[12] Gao RD, Qian SY, Wang HH, Liu YS, Ren SY. Strategies and challenges in treatment of varicose veins and venous insufficiency. World J Clin Cases. 2022 Jun 26;10(18):5946-5956.
[13] de Oliveira Carvalho PE, Magolbo NG, De Aquino RF, Weller CD. Oral aspirin for treating venous leg ulcers. Cochrane Database Syst Rev. 2016 Feb 18;2(2):CD009432.
[14] Briggs M, Flemming K. Living with leg ulceration: a synthesis of qualitative research. J Adv Nurs. 2007 Aug;59(4):319-28.
[15] Varicose veins: diagnosis and management Clinical guideline Published: 24 July 2013
[16] Brandon P. Kitchens Robert J. Snyder Cherison Cuffy, A Literature Review of Pharmacological Agents to Improve Venous Leg Ulcer Healing, July 2020 ISSN 1044-7946 Index Wounds 2020;32(7):195–207.
[17] Lim CS, Davies AH. Graduated compression stockings. CMAJ. 2014 Jul 8;186(10):E391-8.
[18] Palfreyman SJ, Michaels JA. A systematic review of compression hosiery for uncomplicated varicose veins. Phlebology. 2009;24 Suppl 1:13-33.
[19] Amsler F, Willenberg T, Blättler W. In search of optimal compression therapy for venous leg ulcers: a meta-analysis of studies comparing diverse [corrected] bandages with specifically designed stockings [published correction appears in J Vasc Surg. 2010 Jan;51(1):289]. J Vasc Surg. 2009;50(3):668-674.
[20] Raju S, Hollis K, Neglen P. Use of compression stockings in chronic venous disease: patient compliance and efficacy. Ann Vasc Surg. 2007 Nov;21(6):790-5.
[21] Gohel MS, Davies AH. Pharmacological agents in the treatment of venous disease: an update of the available evidence. Curr Vasc Pharmacol. 2009 Jul;7(3):303-8.
[22] Jull AB, Arroll B, Parag V, Waters J. Pentoxifylline for treating venous leg ulcers. Cochrane Database Syst Rev. 2012 Dec 12;12(12):CD001733.
[23] Colgan MP, Dormandy JA, Jones PW, Schraibman IG, Shanik DG, Young RA. Oxpentifylline treatment of venous ulcers of the leg. BMJ. 1990 Apr 14;300(6730):972-5.
[24] Andreozzi GM. Sulodexide in the treatment of chronic venous disease. Am J Cardiovasc Drugs. 2012 Apr 1;12(2):73-81.
[25] Nelson EA. Venous leg ulcers. BMJ Clin Evid. 2011 Dec 21;2011:1902.
[26] Andreozzi GM. Effectiveness of mesoglycan in patients with previous deep venous thrombosis and chronic venous insufficiency. Minerva Cardioangiol. 2007 Dec;55(6):741-53.
[27] McGrath JA, Eady RA. Heparan sulphate proteoglycan and wound healing in skin. J Pathol. 1997;183(3):251–252. doi:10.1002/(SICI)1096-9896(199711)183:33.0.CO;2-H
[28] Jazz Pharmaceuticals Announces FDA Approval of Defitelio® (defibrotide sodium) for the Treatment of Hepatic Veno-Occlusive Disease (VOD) with Renal or Pulmonary Dysfunction Following Hematopoietic Stem-Cell Transplantation (HSCT),March 30, 2016
https://investor.jazzpharma.com/news-releases/news-release-details/jazz-pharmaceuticals-announces-fda-approval-defitelior
[29] Boudet C, Peyrin L. Comparative effect of tropolone and diosmin on venous COMT and sympathetic activity in rat. Arch Int Pharmacodyn Ther. 1986 Oct;283(2):312-20.
[30] Araujo D, Viana F, Osswald W. Diosmin therapy alters the in vitro metabolism of noradrenaline by the varicose human saphenous vein. Pharmacol Res. 1991 Oct;24(3):253-6.
[31] Katsenis K. Micronized purified flavonoid fraction (MPFF): a review of its pharmacological effects, therapeutic efficacy and benefits in the management of chronic venous insufficiency. Curr Vasc Pharmacol. 2005 Jan;3(1):1-9.
[32] Arosio E, Ferrari G, Santoro L, Gianese F, Coccheri S; Mesoglycan Venous Insufficiency Group. A placebo-controlled, double-blind study of mesoglycan in the treatment of chronic venous ulcers. Eur J Vasc Endovasc Surg. 2001 Oct;22(4):365-72.
[33] Tufano A, Arturo C, Cimino E, Di Minno MN, Di Capua M, Cerbone AM, Di Minno G. Mesoglycan: clinical evidences for use in vascular diseases. Int J Vasc Med. Epub 2010 Aug 31.2010;2010:390643.
[34] Coccheri S, Scondotto G, Agnelli G, Aloisi D, Palazzini E, Zamboni V; Venous arm of the SUAVIS (Sulodexide Arterial Venous Italian Study) Group. Randomised, double blind, multicentre, placebo controlled study of sulodexide in the treatment of venous leg ulcers. Thromb Haemost. 2002 Jun;87(6):947-52.
[35] Scondotto G, Aloisi D, Ferrari P, Martini L. Treatment of venous leg ulcers with sulodexide. Angiology. 1999 Nov;50(11):883-9.
[36] Raffetto JD, Marston WA. Venous ulcer: what is new? Plast Reconstr Surg. 2011 Jan;127 Suppl 1:279S-288S.
[37] Martinez-Zapata MJ, Vernooij RW, Uriona Tuma SM, Stein AT, Moreno RM, Vargas E, Capellà D, Bonfill Cosp X. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2016 Apr 6;4(4):CD003229.
[38] Whing J, Nandhra S, Nesbitt C, Stansby G. Interventions for great saphenous vein incompetence. Cochrane Database Syst Rev. 2021 Aug 11;8(8):CD005624.
[39] Medical Advisory Secretariat. Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis. Ont Health Technol Assess Ser. 2011;11(1):1-93. Epub 2011 Feb1.
[40] Lees TA, Beard JD, Ridler BM, Szymanska T. A survey of the current management of varicose veins by members of the Vascular Surgical Society. Annals of the Royal College of Surgeons of England. 1999 Nov;81(6):407.
[41] Sam RC, Silverman SH, Bradbury AW. Nerve injuries and varicose vein surgery. Eur J Vasc Endovasc Surg. 2004 Feb;27(2):113-20.
[42] Critchley G, Handa A, Maw A, Harvey A, Harvey MR, Corbett CR. Complications of varicose vein surgery. Ann R Coll Surg Engl. 1997 Mar;79(2):105-10.
[43] Perrin MR, Guex JJ, Ruckley CV, dePalma RG, Royle JP, Eklof B, Nicolini P, Jantet G. Recurrent varices after surgery (REVAS), a consensus document. REVAS group. Cardiovasc Surg. 2000 Jun;8(4):233-45.
[44] Hoggan BL, Cameron AL, Maddern GJ. Systematic review of endovenous laser therapy versus surgery for the treatment of saphenous varicose veins. Annals of vascular surgery. 2009 Mar 1;23(2):277-87.
[45] Sadick NS. Advances in the treatment of varicose veins: ambulatory phlebectomy, foam sclerotherapy, endovascular laser, and radiofrequency closure. Adv Dermatol. 2006;22:139-56.
[46] Belramman A, Bootun R, Lane TRA, Davies AH. Foam sclerotherapy versus ambulatory phlebectomy for the treatment of varicose vein tributaries: study protocol for a randomised controlled trial. Trials. 2019 Jul 3;20(1):392.
[47] de Roos KP, Nieman FH, Neumann HA. Ambulatory phlebectomy versus compression sclerotherapy: results of a randomized controlled trial. Dermatol Surg. 2003 Mar;29(3):221-6.
[48] Franceschi C, Cappelli M, Ermini S, Gianesini S, Mendoza E, Passariello F, Zamboni P. CHIVA: hemodynamic concept, strategy and results. Int Angiol. 2016 Feb;35(1):8-30. Epub 2015 Jun 5.
[49] Faccini FP, Ermini S, Franceschi C. CHIVA to treat saphenous vein insufficiency in chronic venous disease: characteristics and results. J Vasc Bras. 2019 Jan 30;18:e20180099.
[50] Allegra C. Invasive treatment of varicose veins: a comparison of techniques. Acta Phlebol. 2018 Apr;19:1-2.
[51] Zamboni P, Cisno C, Marchetti F, Mazza P, Fogato L, Carandina S, De Palma M, Liboni A. Minimally invasive surgical management of primary venous ulcers vs. compression treatment: a randomized clinical trial. Eur J Vasc Endovasc Surg. 2003 Apr;25(4):313-8.
[52] ] Aremu MA, Mahendran B, Butcher W, Khan Z, Colgan MP, Moore DJ, Madhavan P, Shanik DG. Prospective randomized controlled trial: conventional versus powered phlebectomy. J Vasc Surg. 2004 Jan;39(1):88-94.
[53] de Zeeuw R, Wittens C, Loots M, Neumann M. Transilluminated powered phlebectomy accomplished by local tumescent anaesthesia in the treatment of tributary varicose veins: preliminary clinical results. Phlebology. 2007;22(2):90-4.
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| Files | ||
| Issue | Vol 11 No 1 (2025) | |
| Section | Review Article(s) | |
| Keywords | ||
| Varicose veins Venous leg ulcers Great saphenous vein saphenopopliteal junction Phlebotonics Intervention treatment | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
W B, S D, P K, A V A. Varicose Vein Treatment and Its Success Rate. JPPM. 2025;11(1):34-44.
