Treatment for Varicose Veins

Abstract

Varicose veins are generally benign. Therefore, treatment is indicated in cases of symptoms and/or stasis dermatitis. Treatment methods are determined by a comprehensive review of the results of ultrasound, interviews, visual inspection and palpation. There are conservative and invasive treatments for varicose veins, with invasive treatment generally chosen for severe cases with stasis dermatitis or ulcers. Approximately 90% of invasive treatments for saphenous varicose veins in Japan involve endovenous thermal ablation using radiofrequency or laser. Endovenous treatment using cyanoacrylate adhesive, which is covered by national insurance in 2019, is suitable for elderly patients, bilateral cases, and treatment of multiple saphenous veins because it does not require TLA anesthesia and postoperative elastic stockings. In recent years, the widespread adoption of minimally invasive treatments has led to an increase in inappropriate treatment with endovenous treatment for cases that do not meet the criteria, which has become a significant societal issue. Inappropriate treatment of asymptomatic or mild cases should never be performed.