What Treatment for Varicose Veins?

Abstract

This century has seen the introduction of several innovative developments in the treatment of varicose veins. No longer are we restricted to conventional sclerotherapy or surgery (saphenofemoral or saphenopopliteal disconnection, with or without stripping of the refluxing truncal vein, and multiple phlebectomies) – although the latter procedure is still the most popular form of management world-wide and is the standard against which newer methods must be judged. Today, we can offer foam sclerotherapy under duplex scan guidance and endothermal ablation (by radiofrequency or laser catheter). Still newer methods, based on glue injection and steam ablation, are being advocated. Ignoring – for now – the super-modern, what is the status of those new methods that have already gained considerable traction in day-to-day surgical practice: foam sclerotherapy, radiofrequency ablation and laser ablation?