A Cotroneo

D Leopardi

G Guyatt

G Roscitano

English

PubMed

Cotroneo A

Roscitano G

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BMC Geriatrics

Indications to surgical treatment in varicose veins

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LECTURE PRESENTATION Open Access
Indications to surgical treatment in varicose veins
G Roscitano*, A Cotroneo
From de Senectute: Age and Health Forum
Catanzaro, Italy. 5-7 December 2009
There isn’t a consensus to the treatment of varicose
veins because we don’t have randomized controlled
trials [1].
Indication to the treatment is based on different cri-
teria: etiological, clinical and diagnostic. The treatments
include: conservative therapy, sclerotherapy, phlebect-
omy, endovenous laser therapy, radiofrequency ablation,
and surgery involving saphenous ligation and stripping
[2].
Short-term advantages appeared to be associated with
sclerotherapy and endovenous treatments, and long-
term effectiveness was more apparent following surgical
intervention. Evidence suggests conservative therapy is
less effective than sclerotherapy and surgery for the
treatment of varicose veins. Ligation with stripping plus
phlebectomy is generally regarded as the “gold standard”
for treating primary long saphenous veins. Sclerotherapy
and surgery both appear to have a place in the manage-
ment of varicose veins. Sclerotherapy and phlebectomy
may also be more appropriate in patients with minor
superficial varicose veins not related to reflux of the
saphenous system or as a post- or adjunctive treatment
to other procedures, such as surgery. Current evidence
suggests endovenous laser therapy and radiofrequency
ablation are as safe and effective as surgery, particularly
in the treatment of saphenous veins. Most importantly,
the type of varicose vein should govern the intervention
of choice, with no single treatment universally employed
[2].
Conclusions
The indications are in evolution. It is very important to
use a duplex scan before the treatment. The results of
the laser at 3 years and of the radiofrequency at 5 years
are similar at surgery but the techniques are less inva-
sive. In the future, sclerotherapy can be better that sur-
gery in particular cases [3].
Published: 19 May 2010
References
1. Guyatt G, et al: Grading strength of recommendations and quality of
evidence in clinical guidelines report from an American college of chest
physicians task force Chest. 2006, 129:174-81.
2. Leopardi D, et al: Systematic review of treatments for varicose veins Ann
Vasc Surg. 2009, 23(2):264-76.
3. Perrin M: Chirurgie à ciel ouvert de l’insuffisance veineuse superficielle
EMC Tecniques Chirurgicales –Chirurgie Vasculaire., 43-161-B: 12p.
doi:10.1186/1471-2318-10-S1-L16
Cite this article as: Roscitano and Cotroneo: Indications to surgical
treatment in varicose veins. BMC Geriatrics 2010 10(Suppl 1):L16.
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Department of Cardiovascular Surgery, Sant’Anna Hospital, Catanzaro, Italy
Roscitano and Cotroneo BMC Geriatrics 2010, 10(Suppl 1):L16
http://www.biomedcentral.com/1471-2318/10/S1/L16
© 2010 Roscitano and Cotroneo; licensee BioMed Central Ltd.


Crossref

al: Grading strength of recommendations and quality of evidence in clinical guidelines report from an American college of chest physicians task force Chest.

al: Systematic review of treatments for varicose veins Ann Vasc Surg.

Submit your next manuscript to BioMed Central and take full advantage of: • Convenient online submission • Thorough peer review • No space constraints or color ﬁgure charges • Immediate publication on acceptance

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3290255

Indications to surgical treatment in varicose veins

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