Friday, December 8, 2023
This activity is intended for dermatologists, plastic surgeons, vascular surgeons, obstetricians/gynecologists, family and general practitioners, and phlebologists.
The goal of this activity is to review the available treatments for varicose veins, with a focus on minimally invasive procedures.
Upon completion of this activity, participants will be able to:
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CME Released: 5/26/2011
Valid for credit through: 5/26/2012, 11:59 PM EST
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Varicose veins are an extremely common medical concern, with documentation of the condition and various interventions dating back thousands of years.[1] They are often unsightly, and cosmetic concern is "the most common reason patients seek consultation."[2] Beyond their appearance, varicose veins are associated with numerous health concerns because they are the visible surface manifestation of some degree of venous insufficiency syndrome. Patients may present with symptoms ranging from aches and cramps to visible ulceration and hemorrhage.[3,4] Even very small varicose veins may be of more than cosmetic concern because the outward signs of venous disease often do not match the significance of the underlying pathology.
Historical records document the universality of the condition as well as early attempts at surgery; stripping and cauterization; compression therapy; and sclerotherapy.[1] Trendelenburg's description of ligation of the great saphenous vein in the late 1800s established the technical foundation for the modern approach to venous surgery.[1] Technical advances in the early 1900s solidified the role of sclerotherapy in the treatment paradigm,[1] and continued research has led to increasingly successful and satisfying outcomes.
As in most areas of medicine, the treatment of varicose veins continues to evolve toward increasingly less invasive interventions. Less invasive therapies are associated with a number of benefits, including reduced treatment time, lower costs, fewer serious side effects, and improved treatment efficiency. These benefits, however, must be balanced against efficacy. Sclerotherapy is a minimally invasive yet effective option for the treatment of smaller varicose veins and is annually reported as one of the most popular cosmetic procedures, ranking seventh overall according to the 2010 American Society for Aesthetic Plastic Surgery's statistics for cosmetic procedures.[5]
In order to achieve optimal outcomes with sclerotherapy, the physician must have a comprehensive understanding of venous disease and the range of available interventions, including the benefits and limitations of each. With the recent approval of polidocanol, it is an opportune time to review the best uses of available sclerosing agents as well as the assessment, treatment, and follow-up strategies that generate the best outcomes. In addition, the increasing study and use of lasers and light therapy for the treatment of telangiectasias warrants a review of these therapies, especially as a helpful adjunct following sclerotherapy.
