الفهرس | Only 14 pages are availabe for public view |
Abstract Summary Varicose veins are dilated superficial veins; usually in the legs. Lower limb V.V. is a common disease that affects almost a quarter of the adult population. They affect women more frequently than men. The most common complaints with varicose veins are a cosmetically displeasing appearance, ankle swelling, calf vein, localized cutaneous pigmentation, and eczema. Complications like ulceration, superficial phlebitis, and hemorrhage are much less common in the general population, but they are disproportionately represented in surgical vein practices. Imaging studies are generally not necessary for diagnosis, but a thorough examination of the extremity with color Doppler US is important. The role of (DUS) to confirm the diagnosis of varicose veins, the extent of truncal reflux, and to plan treatment for people with suspected primary or recurrent varicose veins. Surgical or endovascular ablation of the GSV is indicated when incompetence at the SFJ is present. Surgical ablation in the form of stripping has been considered the “gold standard” against which the less Summary & Conclusion 040 invasive newly introduced endovenous ablation techniques are now compared. Although an effective treatment, surgical ligation and stripping requires anesthesia. Postoperatively patients often have significant discomfort and bruising and routinely require narcotic analgesia. A desire to offer patients a less painful treatment alternative to stripping, with a faster return to work and normal activities, led to the development of endovenous thermal ablation techniques. Endovenous laser treatment (EVLT) and radiofrequency ablation (RF) are rapidly becoming a standard of care in the treatment of varicose veins, because they can offer treatment in an outpatient setting and patients can return to normal activity levels almost immediately. Conclusion: The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have compiled evidencebased recommendations for the care of patients with chronic venous disease. The guidelines encompass recommendations 11.1 through 12.2. Per recommendations 11.1 and 11.2, both ELA and RFA are considered safe and Summary & Conclusion 041 efficacious and are recommended equally for the treatment of saphenous reflux. In addition, both treatments are recommended preferentially to open surgery. Per recommendation 12.1, liquid or foam sclerotherapy is recommended for the treatment of telangiectasias, reticular veins, and varicose veins. Lastly, recommendation 12.2 recommends the use of endovenous thermal ablation over the use of foam sclerotherapy for the treatment of truncal reflux. Sclerotherapy and Foam sclerotherapy is an integral part of treatment of venous insufficiency and should not be regarded as a substitute for surgery but instead as supplementa |