Treatment of varicose vein

Article information

J Korean Med Assoc. 2010;53(11):1006-1014

Publication date (electronic) : 2010 November 15

doi : https://doi.org/10.5124/jkma.2010.53.11.1006

Dai Yun Cho, MD

Department of Thoracic and Cardiovascular Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Corresponding author: Dai Yun Cho, cadywk@cau.ac.kr

Received 2010 September 26; Accepted 2010 October 10.

Abstract

High venous pressure in leg from walking in erect position can lead the development of defective valves and reflux, and superficial veins may become elongated and tortuous. Women are more prone to varicose vein due to hormonal influences and pregnancy. Besides long standing occupation and female gender, there are other risk factors including age, family history, obesity, and prior deep vein thrombosis. Recently developed health related quality of life has contributed to concern more about varicose vein and develop the treatment modalities of varicose vein. Because of the chronicity of the development of varicose vein, most patients are usually accustomed to high venous pressure of their leg and feel minor or no discomfort. Among the reasons to seek for the treatment of varicose vein, cosmetic purpose is the most common. Most patients prefer non-surgical treatment including sclerotheraphy to surgical intervention. High ligation and stripping of varicose vein has remained as the standard treatment of varicose vein with excellent long term results. Minimal invasive non-surgical treatments including radiofrequency ablation and endovenous laser treatment have shown less scars and earlier mobility. Newer treatment modalities have to prove comparable long term results, not merely better cosmetic and short term results. We reviewed about the development of varicose vein and the treatment modalities including preventive measures. Correct comprehension of the patient and proper application of the treatment modality are essential for the good result without recurrence after the treatment of varicose vein.

Keywords: Varicose veins; Therapeutics; Surgical procedures; Sclerotherapy; Laser theraphy

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Figure 1

Schematic drawing of muscle pump. The deep vein is surrounded by the calf muscle. During muscle relaxation, the deep vein is filled with the blood from distal part and the superficial vein through the perforating vein. During contraction, muscle eject the blood from the deep vein to the heart and the valves in the perforating vein are closed to block the flow from the deep vein to the superficial vein.