Skip to main content

Varicose Vein

  • Chapter
  • First Online:
Essential Interventional Radiology Review
  • 1404 Accesses

Abstract

Superficial venous insufficiency, in reference to the lower extremities, refers to a disease process that is both cosmetically unappealing and debilitating, and arises secondary to poor venous drainage within the superficial venous system. Varicose vein, one of the manifestations of this disease, refers to a dilated superficial vein, which can often be symptomatic. About 20% of adults have varicose veins. If telangiectasias and reticular veins are also included, the prevalence increases to around 80%. Duplex ultrasound is the preferred imaging modality for the initial evaluation of venous disease. Minimally invasive treatment options, such as sclerotherapy and endovenous thermal ablation, are available as alternatives to surgery, with fewer complications. Chronic venous insufficiency is a broad condition that encompasses insufficiency related to both superficial and deep venous systems. This chapter provides an overview of the evaluation and management of superficial venous insufficiency.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Further Reading

  • Almeida J, Boatright C. Candidacy for endovenous ablation. Endovasc Today. 2012:27–30.

    Google Scholar 

  • Andriessen A, Apelqvist J, Mosti G, Partsch H, Gonska C, Abel M. Compression therapy for venous leg ulcers: risk factors for adverse events and complications, contraindications – a review of present guidelines. J Eur Acad Dermatol Venereol. 2017;31:1562–8.

    Article  CAS  Google Scholar 

  • Baliyan V, Tajmir S, Hedgire SS, Ganguli S, Prabhakar AM. Lower extremity venous reflux. Cardiovasc Diagn Ther. 2016;6(6):533–43.

    Article  Google Scholar 

  • Biswas S, Clark A, Shields DA. Randomised clinical trial of the duration of compression therapy after varicose vein surgery. Eur J Vasc Endovasc Surg. 2007;33(5):631–7.

    Article  CAS  Google Scholar 

  • Brittenden J, Cotton SC, Elders A, Ramsay CR, Norrie J, Burr J, et al. A randomized trial comparing treatments for varicose veins. N Engl J Med. 2014;371(13):1218–27.

    Article  CAS  Google Scholar 

  • Cronenwett JL, Johnston KW. Rutherford’s vascular surgery. 8th ed. Philadelphia: Elsevier; 2014.

    Google Scholar 

  • Eklof B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL, et al, for the American Venous Forum International Ad Hoc Committee for Revision of the CEAP Classification. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40:1248–52.

    Article  Google Scholar 

  • Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999;53(3):149–53.

    Article  CAS  Google Scholar 

  • Fan CM, Rox-Anderson R. Endovenous laser ablation: mechanism of action. Phlebology. 2008;23(5):206–13.

    Article  Google Scholar 

  • Fletcher J, Moffatt C, Partsch H, Vowden K, Vowden P. Principles of compression in venous disease: a practitioner’s guide to treatment and prevention of venous leg ulcers. Wounds International; 2013.

    Google Scholar 

  • Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. 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;53(5 Suppl):2S–48S.

    Article  Google Scholar 

  • Guo B, Tjosvold L. Endovenous thermal ablation interventions for symptomatic varicose veins of the legs – an update. Institute of Health Economics: Edmonton; 2016.

    Google Scholar 

  • Hamdan A. Management of varicose veins and venous insufficiency. JAMA. 2012;308(24):2612–21.

    Article  CAS  Google Scholar 

  • Hardman RL, Rochon PJ. Role of interventional radiologists in the management of lower extremity venous insufficiency. Semin Interv Radiol. 2013;30(4):388–93.

    Article  Google Scholar 

  • Hettrick H. The science of compression therapy for chronic venous insufficiency edema. J Am Col Certif Wound Spec. 2009;1(1):20–4.

    PubMed  PubMed Central  Google Scholar 

  • Jones RH, Carek PJ. Management of varicose veins. Am Fam Physician. 2008;78(11):1289–94.

    PubMed  Google Scholar 

  • Kabnick LS, Ombrellino M. Ambulatory phlebectomy. Semin Interv Radiol. 2005;22(3):218–24.

    Article  Google Scholar 

  • Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e419S–94S.

    Article  CAS  Google Scholar 

  • Labropoulos N, Tiongson J, Pryor L, et al. Definition of venous reflux in lower-extremity veins. J Vasc Surg. 2003;38(4):793–8.

    Article  Google Scholar 

  • Lim CS, Davies AH. Graduated compression stockings. CMAJ. 2014;186(10):E391–8.

    Article  Google Scholar 

  • Malskat WS, Poluektova AA, van der Geld CW, Neumann HA, Weiss RA, Bruijninckx CM, et al. Endovenous laser ablation (EVLA): a review of mechanisms, modeling outcomes, and issues for debate. Lasers Med Sci. 2014;29(2):393–403.

    Article  Google Scholar 

  • Mauro MA, Murphy K, Thomson KR, Venbrux AC, Morgan RA. Image-guided interventions. 2nd ed. Philadelphia: Saunders Elsevier; 2013.

    Google Scholar 

  • Medical Advisory Secretariat. Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis. Ont Health Technol Assess Ser. 2011;11(1):1–93.

    PubMed Central  Google Scholar 

  • Meissner MH, Moneta G, Burnand K, Gloviczki P, Lohr JM, Lurie F, et al. The hemodynamics and diagnosis of venous disease. J Vasc Surg. 2007;46(6):S4–S24.

    Article  Google Scholar 

  • Min RJ, Khilnani N, Zimmet SE. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 2003;14(8):991–6.

    Article  Google Scholar 

  • Nesbitt C, Bedenis R, Bhattacharya V, Stansby G. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for great saphenous vein varices. Cochrane Database Syst Rev. 2014;(7):CD005624.

    Google Scholar 

  • Nijsten T, van den Bos RR, Goldman MP, Kockaert MA, Proebstle TM, Rabe E, et al. Minimally invasive techniques in the treatment of saphenous varicose veins. J Am Acad Dermatol. 2009;60(1):110–9.

    Article  Google Scholar 

  • Piazza G. Varicose veins. Circulation. 2014;130:582–7.

    Article  Google Scholar 

  • Proebstle, TM, et al. Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: first clinical experience. J Vasc Surg. 2008;47(1):151–6.e1.

    Google Scholar 

  • Puggioni A, Kalra M, Carmo M, Mozes G, Gloviczki P. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg. 2005;42(3):488–93.

    Article  Google Scholar 

  • Rabe E, Partsch H, Morrison N, Meissner MH, Mosti G, Lattimer CR, et al. Risks and contraindications of medical compression treatment - a critical reappraisal. An international consensus statement. Phlebology. 2020:1–14.

    Google Scholar 

  • Rutherford RB, Padberg FT Jr, Comerota AJ, Kistner RL, Meissner MH, Moneta GL. Venous severity scoring: a adjunct to venous outcome assessment. J Vasc Surg. 2000;31:1307–12.

    Article  CAS  Google Scholar 

  • Sadovsky R. Managing lower extremity venous ulcers. Am Fam Physician. 2003;68(4):755.

    Google Scholar 

  • Terrie Y. Recognizing and treating venous stasis ulcers. US Pharm. 2017;42(2):36–9.

    Google Scholar 

  • Theivacumar N, Dellagrammaticas D, Mavor A, Gough M. Endovenous laser ablation: does standard above-knee great saphenous vein ablation provide optimum results in patients with both above- and below-knee reflux? A randomized controlled trial. J Vasc Surg. 2008;48:173–8.

    Article  Google Scholar 

  • van der Velden SK, Biemans AA, De Maeseneer MG, Kockaert MA, Cuypers PW, Hollestein LM, et al. Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins. Br J Surg. 2015;102(10):1184–94.

    Article  Google Scholar 

  • Waybill PN, Brown DB. Patient care in vascular and interventional radiology. 3rd ed. Fairfax: Society of Interventional Radiology; 2016.

    Google Scholar 

  • Youn YJ, Lee J. Chronic venous insufficiency and varicose veins of the lower extremities. Korean J Intern Med. 2019;34(2):269–83.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anushi Patel .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Patel, A. (2022). Varicose Vein. In: Chand, R., Eltorai, A.E.M., Healey, T., Ahn, S. (eds) Essential Interventional Radiology Review. Springer, Cham. https://doi.org/10.1007/978-3-030-84172-0_27

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-84172-0_27

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84171-3

  • Online ISBN: 978-3-030-84172-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics