The treatment of varicose veins and CVD requires the removal, occlusion or ligation of the affected vessels or perforators to encourage the venous blood to be redirected or bypass the incompetent vein(s). Until recently surgical management has been the “Gold-Standard” of management of an incompetent GSV and perforator veins. However, catheter-based endovenous techniques have been developed over the last 2-3 decades and now provide the same, if not improved results (as measured by success of vessel occlusion and length of time until recurrence) and can have a safer risk profile.
The basis of most treatment plans is to treat the main source of reflux in the main trunks (GSV and/or SSV) or perforator vessel(s) with surgical or endovenous techniques. Once the main source of reflux disease is treated, the tributaries, visible Varicose and Spider veins can be managed with other modalities, mainly sclerotherapy with or without phlebectomy. This multimodal approach provides each patient with a customised treatment plan that treats all aspects of their venous incompetence disease.