Varicose Vein Treatment in South Korea

Abstract

The varicose vein is one of the most common diseases in the field of vascular surgery. In Korea, about 140,000–156,000 patients are treated for varicose veins per year. About 25 % of the varicose vein patients were managed after admission. About 15,000–17,000 patients underwent open surgery per year, which shows a slightly decreasing trend. The open procedure was most commonly performed in private clinic, followed by a general hospital, hospital, and a tertiary hospital. Although the exact number of endovenous procedures is unknown, it can be estimated that endovenous thermal ablations such as endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) are most commonly performed. Duplex scanning is recommended as the first diagnostic test for all patients with suspected varicose veins. Reflux time is generally used to diagnose the valvular reflux. Reflux can be demonstrated either using a Valsalva maneuver or by the augmentation of flow resulting from squeezing the calf. The diameter of the saphenous vein can be used as an alternative parameter if the interpretation of the duplex scanning is not conclusive. In the study of Korean patients, great saphenous veins with a diameter ≥5.05 mm and small saphenous veins with a diameter ≥3.55 mm were the best positive predictive values for pathologic reflux. With the early introduction of RFA, the registry and consensus for the standard procedure for RFA were made in Korea.