Surgical treatment of varicose veins

Abstract

This article has been directed at the surgical management of varicose veins, although many forms can be equally or more satisfactorily treated by compression sclerotherapy. This is particularly suited to the treatment of residual and recurrent varicose veins in the lower leg. It is possible that a combined approach of distal injection and proximal surgery provides the most satisfactory long-term results. The results of surgical management of varicose veins are difficult to interpret since the type of venous disorder treated is not always clearly defined and the natural history of the various forms is not fully understood. Many patients have had a number of different forms of treatment whose relative value is therefore difficult to interpret. It is advisable to wait 5 years before judging the success of any treatment in this field. Surgery for primary varicose veins should be reserved for patients with marked symptoms and extensive varicosities. When undertaken, it should be well planned and radical enough to cure the patient of both symptoms and varicosities. The surgeon looking after a patient with a post-thrombotic syndrome must be willing to follow-up the patient indefinitely because surgery represents only one aspect of the long-term management.