INTRODUCTION We aimed to analyse national trends in varicose vein treatment in the UK National Health Service (NHS). SUBJECTS AND METHODS The National Hospital Episode Statistics website () was interrogated for patients treated (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) in the NHS for varicose veins. RESULTS There has been a 34% decline in patients presenting for an intervention for varicose veins. For surgical procedures alone, the waiting times have fallen by 59%. In 200759%. In -2008 fewer bed days were used in comparison to 1998; accompanied by a 49% decline in the number of patients undergoing surgery. After a 47% decrease between 1998 and 2001, the number of patients requesting sclerotherapy treatment has increased by a substantial 311% over the subsequent 7 years. Transluminal procedures were used almost twice as often in 2007-2008 as in 2006-2007. CONCLUSIONS There has been a steady decline in the number of patients treated for varicose veins. Fewer patients are undergoing surgery but are being managed more efficiently, with an increase in day cases and a reduction in total bed days. The demand for minimally invasive procedures has increased substantially. These trends will be of great importance for the future planning of vascular surgical services.

surgery remains an effective tool in the management of TOS. A simple patient-directed questionnaire as used in this study could assist in the standardisation of outcome assessment.

In a population of older hypertensive patients, higher plasma homocysteine was associated with cognitive decline.

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