Varicose Veins and Lower Extremity Venous Insufficiency

Abstract

Lower extremity venous insufficiency and varicose veins are common conditions, affecting up to 25% of women. Herein, we review the pathophysiology of lower extremity venous insufficiency and varicose veins, the epidemiology of varicose veins, clinical diagnosis, and ultrasonographic diagnosis. We also discuss treatment rationale, algorithms, and techniques, with a focus on endovenous great saphenous vein ablation.

Keywords

varicose veins - venous insufficiency - laser ablation

• References

• 1 Min RJ. Lower extremity superficial venous insufficiency: percutaneous techniques of management. Endovasc Manag Venous Dis 2000; 3: 54-59
• 2 Fan C-M. Epidemiology and pathophysiology of varicose veins. Tech Vasc Interv Radiol 2003; 6 (03) 108-110
• 3 Stansby G. Women, pregnancy, and varicose veins. Lancet 2000; 355 (9210): 1117-1118
• 4 Cornu-Thenard A, Boivin P, Baud JM, De Vincenzi I, Carpentier PH. Importance of the familial factor in varicose disease. Clinical study of 134 families. J Dermatol Surg Oncol 1994; 20 (05) 318-326
• 5 Laurikka JO, Sisto T, Tarkka MR, Auvinen O, Hakama M. Risk indicators for varicose veins in forty- to sixty-year-olds in the Tampere varicose vein study. World J Surg 2002; 26 (06) 648-651
• 6 Kurz X, Lamping DL, Kahn SR. , et al; VEINES Study Group. Do varicose veins affect quality of life? Results of an international population-based study. J Vasc Surg 2001; 34 (04) 641-648
• 7 Abenhaim L, Kurz X. ; VEINES Group. The VEINES study (VEnous Insufficiency Epidemiologic and Economic Study): an international cohort study on chronic venous disorders of the leg. Angiology 1997; 48 (01) 59-66
• 8 Khilnani NM, Min RJ. Duplex ultrasound for superficial venous insufficiency. Tech Vasc Interv Radiol 2003; 6 (03) 111-115
• 9 Masuda EM, Kistner RL, Eklof B. Prospective study of duplex scanning for venous reflux: comparison of Valsalva and pneumatic cuff techniques in the reverse Trendelenburg and standing positions. J Vasc Surg 1994; 20 (05) 711-720
• 10 van Bemmelen PS, Bedford G, Beach K, Strandness DE. Quantitative segmental evaluation of venous valvular reflux with duplex ultrasound scanning. J Vasc Surg 1989; 10 (04) 425-431
• 11 Sandri JL, Barros FS, Pontes S, Jacques C, Salles-Cunha SX. Diameter-reflux relationship in perforating veins of patients with varicose veins. J Vasc Surg 1999; 30 (05) 867-874
• 12 O'Donnell Jr TF. The present status of surgery of the superficial venous system in the management of venous ulcer and the evidence for the role of perforator interruption. J Vasc Surg 2008; 48 (04) 1044-1052
• 13 Puggioni A, Lurie F, Kistner RL, Eklof B. How often is deep venous reflux eliminated after saphenous vein ablation?. J Vasc Surg 2003; 38 (03) 517-521
• 14 Rosenblatt M. Percutaneous management of varicose veins. Sci Sess Sci Poster Abstr 2002; 13: 258-262
• 15 Gloviczki P, Comerota AJ, Dalsing MC. , et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guideline of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011; 53 (5 Suppl): 2S-48S
• 16 Kabnick LS, Cayne N, Jacobowitz G. , et al. Endovenous procedures in varicose veins: What is the best choice today?. Phlebology 2008; 8: 229-235
• 17 Ahn SH, Gill G, Prince EA. , et al. Endovenous laser ablation (EVLA) performed with 1470 nm laser: long term outcomes and comparison with 980 nm laser. J Vasc Interv Radiol 2013; 24: S144
• 18 Chehab M, Dixit P, Antypas E, Juncaj M, Wong O, Bischoff M. Endovenous laser ablation of perforating veins: feasibility, safety, and occlusion rate using a 1,470-nm laser and bare-tip fiber. J Vasc Interv Radiol 2015; 26 (06) 871-877
• 19 Darwood RJ, Theivacumar N, Dellagrammaticas D, Mavor AI, Gough MJ. Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins. Br J Surg 2008; 95 (03) 294-301