الفهرس 
IntroductionOnly 14 pages are availabe for public view
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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