What is effective care for varicose veins?

Abstract

Varicose veins affect one-quarter to one-third of Western adult populations and consume an increasing amount of health care resources. Much of this increased utilization has been driven by the advent of minimally invasive technology including endovenous thermal ablation, foam sclerotherapy, and more recently mechanicochemical and cyanoacrylate glue ablation. This has largely been driven by patient and physician preferences in the absence of robust evidence that one therapy is truly superior to another. This partially arises from misunderstandings about appropriate outcomes measures and what truly constitutes effective treatment of varicose veins. Technical outcomes, such as saphenous closure rates, have frequently been used as surrogates for effective treatment but are poorly correlated with symptom improvement, quality of life, and risk of recurrence. Although there does appear to be a trend towards higher recurrence with ultrasound-guided foam sclerotherapy, the data are occasionally conflicting and there does not appear to be substantial differences between the various modalities. Similarly, there do not appear to be major differences in late quality of life measures between these treatment options. As long-term differences in recurrence and quality of life are small, overall cost effectiveness is driven primarily by initial treatment costs and ultrasound-guided foam sclerotherapy is the most cost-effective strategy in many models. However, there continues to be substantial uncertainty surrounding cost estimates and other factors of importance to the patient may ultimately drive treatment decisions. The benefits of some adjuncts to the treatment of axial superficial reflux, such as the concurrent versus staged management of tributary varicosities, remain ill-defined while that of others, such as routine post-procedural ultrasound surveillance and compression, need critical re-evaluation.

Comparative assessment of the efficiency of different methods of surgical treatment for varicose veins

“…Вступ. На варикозну хворобу нижніх кінцівок (ВХ) страждає 10-15% населення [1,2], причому в деяких регіонах її поширеність сягає 25% [3]. ВХ підлягає хірургічному лікуванню [4][5][6].…”

Вплив Гонартрозу На Перебіг І Ефективність Лікування Варикозної Хвороби Вен Нижніх Кінцівок

“…Варикозной болезнью вен (ВБВ) страдает 10-15 % населения [4,10], причем в некоторых регионах ее распространенность достигает 25 % [6], а заболеваемость каждый год увеличивается в среднем на 2 % [7]. Существуют тесные связи между ВБВ голеней и гонартрозом (ГА), взаимоусугубляющие течение друг друга [1,3,9].…”

Efficacy of endovascular laser coagulation with different radiation power in patients with varicose veins disease of lower limb

“…Варикозной болезнью вен (ВБВ) страдают 10-15 % населения [4,11], причем в некоторых регионах ее рас-пространенность достигает 25 % [7], а заболеваемость каждый год увеличивается в среднем на 2 % [8]. Не-ким золотым стандартом лечения ВБВ считается эн-довенозная (эндоваскулярная) лазерная коагуляция (ЭВЛК) [1,9,12], которая является относительно безо-пасным и эффективным методом внутрисосудистой абляции варикозных вен разной степени тяжести [6,11].…”