Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202300642
Jornal Vascular Brasileiro
Guideline

Brazilian guidelines on chronic venous disease of the Brazilian Society of Angiology and Vascular Surgery

Diretriz brasileira de doença venosa crônica da Sociedade Brasileira de Angiologia e de Cirurgia Vascular

Rodrigo Kikuchi; Claudio Nhuch; Daniel Autran Burlier Drummond; Fabricio Rodrigues Santiago; Felipe Coelho Neto; Fernanda de Oliveira Mauro; Fernando Trés Silveira; Guilherme Peralta Peçanha; Ivanesio Merlo; Jose Marcelo Corassa; Leonardo Stambowsky; Marcondes Figueiredo; Miriam Takayanagi; Ronald Luiz Gomes Flumignan; Solange Seguro Meyge Evangelista; Walter Campos Jr.; Edwaldo Edner Joviliano; Walter Junior Boim de Araujo; Julio Cesar Peclat de Oliveira

Downloads: 13
Views: 346

Abstract

The Brazilian Society of Angiology and Vascular Surgery has set up a committee to provide new evidence-based recommendations for patient care associated with chronic venous insufficiency. Topics were divided in five groups: 1. Classification, 2. Diagnosis, 3. Conservative or non-invasive treatment, 4. Invasive treatment and 5. Treatment of small vessels. This last series is closely related to the activities of Brazilian angiologists and vascular surgeons, who are heavily involved in the treatment of small superficial veins. These guidelines are intended to assist in clinical decision-making for attending physicians and health managers. The decision to follow a guideline recommendation should be made by the responsible physician on a case-by-case basis taking into account the patient's specific condition, as well as local resources, regulations, laws, and clinical practice recommendations.

Keywords

venous insufficiency, guideline, varicose veins, venous disease, treatment

Resumo

A Sociedade Brasileira de Angiologia e de Cirurgia Vascular organizou uma comissão para fornecer novas recomendações baseadas em evidências sobre questões críticas de atendimento ao paciente com insuficiência venosa crônica. São abordados aqui os temas de classificação, diagnóstico, tratamento conservador, tratamento invasivo e tratamento de pequenos vasos. Esta última série está muito relacionada à atividade de angiologistas e cirurgiões vasculares, que possuem forte atuação no tratamento de pequenas veias superficiais. Estas diretrizes destinam-se a auxiliar na tomada de decisões clínicas de médicos assistentes e gestores de saúde. A decisão de seguir uma recomendação de diretriz deve ser feita pelo médico responsável caso a caso, levando em consideração a condição específica do paciente, bem como recursos locais, regulamentos, leis e recomendações de prática clínica.

Palavras-chave

insuficiência venosa, diretriz, varizes, doença venosa, tratamento

References

1 Eklof B, Perrin M, Delis KT, et al. Updated terminology of chronic venous disorders: the VEIN-TERM transatlantic interdisciplinary consensus document. J Vasc Surg. 2009;49(2):498-501. http://dx.doi.org/10.1016/j.jvs.2008.09.014. PMid:19216970.

2 Beebe HG, Bergan JJ, Bergqvist D, et al. Classification and grading of chronic venous disease in the lower limbs. A consensus statement. Eur J Vasc Endovasc Surg. 1996;12(4):487-91, discussion 491-2. http://dx.doi.org/10.1016/S1078-5884(96)80019-0. PMid:8980442.

3 Eklöf B, Rutherford RB, Bergan JJ, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40(6):1248-52. http://dx.doi.org/10.1016/j.jvs.2004.09.027. PMid:15622385.

4 Salim S, Machin M, Patterson BO, Onida S, Davies AH. Global epidemiology of chronic venous disease: a systematic review with pooled prevalence analysis. Ann Surg. 2021;274(6):971-6. http://dx.doi.org/10.1097/SLA.0000000000004631. PMid:33214466.

5 Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999;53(3):149-53. http://dx.doi.org/10.1136/jech.53.3.149. PMid:10396491.

6 Robertson LA, Evans CJ, Lee AJ, Allan PL, Ruckley CV, Fowkes FG. Incidence and risk factors for venous reflux in the general population: Edinburgh Vein Study. Eur J Vasc Endovasc Surg. 2014;48(2):208-14. http://dx.doi.org/10.1016/j.ejvs.2014.05.017. PMid:24951373.

7 Phillips MN, Jones GT, van Rij AM, Zhang M. Micro-venous valves in the superficial veins of the human lower limb. Clin Anat. 2004;17(1):55-60. http://dx.doi.org/10.1002/ca.10141. PMid:14695589.

8 Vincent JR, Jones GT, Hill GB, van Rij AM. Failure of microvenous valves in small superficial veins is a key to the skin changes of venous insufficiency. J Vasc Surg. 2011;54(6, Suppl):62S-9S, e1-3. http://dx.doi.org/10.1016/j.jvs.2011.06.085. PMid:21917406.

9 Raffetto JD. Pathophysiology of chronic venous disease and venous ulcers. Surg Clin North Am. 2018;98(2):337-47. https://doi.org/10.1016/j.suc.2017.11.002.

10 Mansilha A, Sousa J. Pathophysiological mechanisms of chronic venous disease and implications for venoactive drug therapy. Int J Mol Sci. 2018;19(6):1669. http://dx.doi.org/10.3390/ijms19061669. PMid:29874834.

11 Labropoulos N, Giannoukas AD, Delis K, et al. Zhere does venous reflux start? J Vasc Surg. 1997;26(5):736-42. http://dx.doi.org/10.1016/S0741-5214(97)70084-3. PMid:9372809.

12 Lee BB, Nicolaides AN, Myers K, et al. Venous hemodynamic changes in lower limb venous disease: the UIP consensus according to scientific evidence. Int Angiol. 2016;35(3):236-352. PMid:27013029.

13 Labropoulos N, Patel PJ, Tiongson JE, Pryor L, Leon LR Jr, Tassiopoulos AK. Patterns of venous reflux and obstruction in patients with skin damage due to chronic venous disease. Vasc Endovascular Surg. 2007;41(1):33-40. http://dx.doi.org/10.1177/1538574406296246. PMid:17277241.

14 Bollinger A, Leu AJ, Hoffmann U, Franzeck UK. Microvascular changes in venous disease: an update. Angiology. 1997;48(1):27-32. http://dx.doi.org/10.1177/000331979704800105. PMid:8995340.

15 Raju S, Knight A, Lamanilao L, Pace N, Jones T. Peripheral venous hypertension in chronic venous disease. J Vasc Surg Venous Lymphat Disord. 2019;7(5):706-14. http://dx.doi.org/10.1016/j.jvsv.2019.03.006. PMid:31196767.

16 Perrin M, Eklof B, Van Rij A, et al. Venous symptoms: the SYM Vein Consensus statement developed under the auspices of the European Venous Forum. Int Angiol. 2016;35(4):374-98. PMid:27081866.

17 Van der Velden SK, Shadid NH, Nelemans PJ, Sommer A. How specific are venous symptoms for diagnosis of chronic venous disease? Phlebology. 2014;29(9):580-6. http://dx.doi.org/10.1177/0268355513515859. PMid:24390751.

18 Wrona M, Jockel KH, Pannier F, Bock E, Hoffmann B, Rabe E. Association of venous disorders with leg symptoms: results from the Bonn Vein Study 1. Eur J Vasc Endovasc Surg. 2015;50(3):360-7. http://dx.doi.org/10.1016/j.ejvs.2015.05.013. PMid:26141786.

19 Vuylsteke ME, Thomis S, Guillaume G, Modliszewski ML, Weides N, Staelens I. Epidemiological study on chronic venous disease in Belgium and Luxembourg: prevalence, risk factors, and symptomatology. Eur J Vasc Endovasc Surg. 2015;49(4):432-9. http://dx.doi.org/10.1016/j.ejvs.2014.12.031. PMid:25701071.

20 Serra R, Ielapi N, Bevacqua E, et al. Haemorrhage from varicose veins and varicose ulceration: a systematic review. Int Wound J. 2018;15(5):829-33. http://dx.doi.org/10.1111/iwj.12934. PMid:29808553.

21 Vasquez M, Rabe E, McLafferty R, et al. Revision of the venous clinical severity score: venous outcomes consensus statement: special communication of the American Venous Forum Ad Hoc Outcomes Working Group. J Vasc Surg. 2010;52(5):1387-96. http://dx.doi.org/10.1016/j.jvs.2010.06.161. PMid:20875713.

22 Passman MA, McLafferty RB, Lentz MF, et al. Validation of Venous Clinical Severity Score (VCSS) with other venous severity assessment tools from the American Venous Forum, National Venous Screening Program. J Vasc Surg. 2011;54(6, Suppl):2S-9S. http://dx.doi.org/10.1016/j.jvs.2011.05.117. PMid:21962926.

23 Villalta SBP, Picolli A, Lensing A, Prins M, Prandoni P. Assessment of validity and reproducibility of a clinical scale for the post thrombotic syndrome. Haemostasis. 1994;24:157.

24 Kahn SR. Measurement properties of the Villalta scale to define and classify the severity of the post-thrombotic syndrome. J Thromb Haemost. 2009;7(5):884-8. http://dx.doi.org/10.1111/j.1538-7836.2009.03339.x. PMID: 19320818.

25 Garratt AM, Macdonald LM, Ruta DA, Russell IT, Buckingham JK, Krukowski ZH. Towards measurement of outcome for patients with varicose veins. Qual Health Care. 1993;2(1):5-10. http://dx.doi.org/10.1136/qshc.2.1.5. PMid:10132081.

26 Launois R, Reboul-Marty J, Henry B. Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res. 1996;5(6):539-54. http://dx.doi.org/10.1007/BF00439228. PMid:8993100.

27 Lamping DL, Schroter S, Kurz X, Kahn SR, Abenhaim L. Evaluation of outcomes in chronic venous disorders of the leg: development of a scientifically rigorous, patient-reported measure of symptoms and quality of life. J Vasc Surg. 2003;37(2):410-9. http://dx.doi.org/10.1067/mva.2003.152. PMid:12563215.

28 Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-200. http://dx.doi.org/10.1093/eurheartj/ehw128. PMid:27206819.

29 Carman TL, Al-Omari A. Evaluation and management of chronic venous disease using the foundation of CEAP. Curr Cardiol Rep. 21:114. https://doi.org/10.1007/s11886-019-1201-1.

30 Scuderi A, Raskin B, Al Assal F, et al. The incidence of venous disease in Brazil based on the CEAP classification. Int Angiol. 2002;21(4):316-21. PMid:12518109.

31 Lurie F, Passman M, Meisner M, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020;8(3):342-52. http://dx.doi.org/10.1016/j.jvsv.2019.12.075. PMid:32113854.

32 Hess CT. Venous ulcer assessment and management: using the updated CEAP Classification System. Adv Skin Wound Care. 2020;33(11):614-5. http://dx.doi.org/10.1097/01.ASW.0000719052.33284.73. PMid:33065684.

33 Lurie F, De Maeseneer MGR. The 2020 Update of the CEAP Classification: what is new? Eur J Vasc Endovasc Surg. 2020;59(6):859-60. http://dx.doi.org/10.1016/j.ejvs.2020.04.020. PMid:32376218.

34 Salim S, Machin M, Patterson BO, Onida S, Davies AH. Global epidemiology of chronic venous disease: a systematic review with pooled prevalence analysis. Ann Surg. 2021;274(6):971-6. http://dx.doi.org/10.1097/SLA.0000000000004631. PMid:33214466.

35 Naleini F, Hassani M, Bagherhosseini N, Sobhiyeh M. Ultrasonographic measurement of saphenous vein diameter compared to CEAP classification in patients with varicose veins. J Vasc Nurs. 2022;40(1):43-6. http://dx.doi.org/10.1016/j.jvn.2021.11.003. PMid:35287833.

36 Moura RM, Gonçalves GS, Navarro TP, Britto RR, Dias RC. Relationship between quality of life and the CEAP clinical classification in chronic venous disease. Rev Bras Fisioter. 2010;14(2):99-105. http://dx.doi.org/10.1590/S1413-35552010005000007. PMid:20464164.

37 Marston WA, Vasquez MA, Lurie F, et al. Multicenter assessment of the repeatability and reproducibility of the revised Venous Clinical Severity Score (rVCSS). J Vasc Surg Venous Lymphat Disord. 2013;1(3):219-24. http://dx.doi.org/10.1016/j.jvsv.2012.10.059. PMid:26992578.

38 I Y, Karakelle SG, Aydın GT, R M, T O, Iu A. The relationship between clinical severity and outcome measures in patients with chronic venous insufficiency with or without leg ulcer. J Tissue Viability. 2021;30(3):310-6. http://dx.doi.org/10.1016/j.jtv.2021.06.002. PMid:34140210.

39 Mallick S, Sarkar T, Gayen T, Naskar B, Datta A, Sarkar S. Correlation of venous clinical severity score and venous disability score with dermatology life quality index in chronic venous insufficiency. Indian J Dermatol. 2020;65(6):489-94. http://dx.doi.org/10.4103/ijd.IJD_485_20. PMid:33487704.

40 Vasquez MA, Munschauer CE. Revised venous clinical severity score: a facile measurement of outcomes in venous disease. Phlebology. 2012;27(Suppl 1):119-29. http://dx.doi.org/10.1258/phleb.2012.012s16. PMid:22312078.

41 dos Santos VP, Queiroz AB. Venous disease classifications and generic and disease-specific quality of life questionnaires: which, why, and when to use? J Vasc Bras. 2019;18:e20190114. PMid:31807131.

42 Catarinella FS, Nieman FH, Wittens CH. An overview of the most commonly used venous quality of life and clinical outcome measurements. J Vasc Surg Venous Lymphat Disord. 2015;3(3):333-40. http://dx.doi.org/10.1016/j.jvsv.2014.09.003. PMid:26992316.

43 Dong Z, Zhao Y, Zhao X, et al. Summary of diagnostic and characteristic parameters of C0to C2patients based on the CEAP2020 classification. J Vasc Surg Venous Lymphat Disord. 2022;10(6):1201-1207.e2. http://dx.doi.org/10.1016/j.jvsv.2022.05.007. PMID: 35810993.

44 Bissacco D, Oberto S. C0a and C0s patients: potential benefits for an unclear population. Int Angiol. 2018;37(6):486. http://dx.doi.org/10.23736/S0392-9590.18.04029-4. PMid:30203641.

45 Engelhorn CA, Engelhorn AL, Cassou MF, Salles-Cunha S. Patterns of saphenous venous reflux in women presenting with lower extremity telangiectasias. Dermatol Surg. 2007;33(3):282-8. PMid:17338684.

46 Benigni JP, Bihari I, Rabe E, et al. Venous symptoms in C0 and C1 patients: UIP consensus document. Int Angiol. 2013;32(3):261-5. PMid:23711678.

47 Lugli M, Maleti O, Iabichella ML, Perrin M. Investigation of non-saphenous veins in C0S patients. Int Angiol. 2018;37(2):169-75. http://dx.doi.org/10.23736/S0392-9590.18.03901-9. PMid:29376624.

48 Prochaska JH, Arnold N, Falcke A, et al. Chronic venous insufficiency, cardiovascular disease, and mortality: a population study. Eur Heart J. 2021;42(40):4157-65. http://dx.doi.org/10.1093/eurheartj/ehab495. PMid:34387673.

49 Konoeda H, Yamaki T, Hamahata A, Ochi M, Sakurai H. Quantification of superficial venous reflux by duplex ultrasound-role of reflux velocity in the assessment the clinical stage of chronic venous insufficiency. Ann Vasc Dis. 2014;7(4):376-82. http://dx.doi.org/10.3400/avd.oa.14-00047. PMid:25593622.

50 Panpikoon T, Wedsart B, Treesit T, Chansanti O, Bua-Ngam C. Duplex ultrasound findings and clinical classification of lower extremity chronic venous insufficiency in a Thai population. J Vasc Surg Venous Lymphat Disord. 2019;7(3):349-55. http://dx.doi.org/10.1016/j.jvsv.2018.08.012. PMid:30477978.

51 Garcia R, Labropoulos N. Duplex ultrasound for the diagnosis of acute and chronic venous diseases. Surg Clin North Am. 2018;98(2):201-18. http://dx.doi.org/10.1016/j.suc.2017.11.007. PMid:29502767.

52 Malgor RD, Labropoulos N. Diagnosis and follow-up of varicose veins with duplex ultrasound: how and why? Phlebology. 2012;27(Suppl 1):10-5. http://dx.doi.org/10.1258/phleb.2011.012s05. PMid:22312061.

53 Santiago FR, Piscoya M, Chi YW. A sonographic study of thigh telangiectasias. Phlebology. 2018;33(7):500-1. http://dx.doi.org/10.1177/0268355517717404. PMid:28683584.

54 Engelhorn CA, Engelhorn AL, Cassou MF, Salles-Cunha S. Patterns of saphenous venous reflux in women presenting with lower extremity telangiectasias. Dermatol Surg. 2007;33(3):282-8. PMid:17338684.

55 Ruckley CV, Allan PL, Evans CJ, Lee AJ, Fowkes FG. Telangiectasia and venous reflux in the Edinburgh Vein Study. Phlebology. 2012;27(6):297-302. http://dx.doi.org/10.1258/phleb.2011.011007. PMid:22106449.

56 Yun S. Ultrasound-based topographic analysis of tributary vein connection with the saphenous vein during ambulatory conservative hemodynamic correction of chronic venous insufficiency. J Vasc Surg Venous Lymphat Disord. 2019;7(3):356-63. http://dx.doi.org/10.1016/j.jvsv.2018.09.011. PMid:30777672.

57 Engelhorn CA, Manetti R, Baviera MM, et al. Progression of reflux patterns in saphenous veins of women with chronic venous valvular insufficiency. Phlebology. 2012;27(1):25-32. http://dx.doi.org/10.1258/phleb.2011.010077. PMid:21903684.

58 García Carriazo M, Gómez de las Heras C, Mármol Vázquez P, Ramos Solís MF. Doppler ultrasound study and venous mapping in chronic venous insufficiency. Radiologia (Madr). 2016;58(1):7-15. http://dx.doi.org/10.1016/j.rxeng.2015.10.001. PMid:26655801.

59 Metzger PB, Rossi FH, Kambara AM, et al. Criteria for detecting significant chronic iliac venous obstructions with duplex ultrasound. J Vasc Surg Venous Lymphat Disord. 2016;4(1):18-27. http://dx.doi.org/10.1016/j.jvsv.2015.07.002. PMid:26946891.

60 Villalba L, Larkin TA. Transabdominal duplex ultrasound and intravascular ultrasound planimetry measures of common iliac vein stenosis are significantly correlated in a symptomatic population. J Vasc Surg Venous Lymphat Disord. 2021;9(5):1273-81. http://dx.doi.org/10.1016/j.jvsv.2021.01.015. PMid:33548556.

61 Labropoulos N, Jasinski PT, Adrahtas D, Gasparis AP, Meissner MH. A standardized ultrasound approach to pelvic congestion syndrome. Phlebology. 2017;32(9):608-19. http://dx.doi.org/10.1177/0268355516677135. PMid:27799418.

62 Sloves J, Almeida JI. Venous duplex ultrasound protocol for iliocaval disease. J Vasc Surg Venous Lymphat Disord. 2018;6(6):748-57. http://dx.doi.org/10.1016/j.jvsv.2018.06.005. PMid:30336903.

63 Coelho A, O’Sullivan G. Usefulness of direct computed tomography venography in predicting inflow for venous reconstruction in chronic post-thrombotic syndrome. Cardiovasc Intervent Radiol. 2019;42(5):677-84. http://dx.doi.org/10.1007/s00270-019-02161-5. PMid:30627773.

64 Gagne PJ, Tahara RW, Fastabend CP, et al. Venography versus intravascular ultrasound for diagnosing and treating iliofemoral vein obstruction. J Vasc Surg Venous Lymphat Disord. 2017;5(5):678-87. http://dx.doi.org/10.1016/j.jvsv.2017.04.007. PMid:28818221.

65 Montminy ML, Thomasson JD, Tanaka GJ, Lamanilao LM, Crim W, Raju S. A comparison between intravascular ultrasound and venography in identifying key parameters essential for iliac vein stenting. J Vasc Surg Venous Lymphat Disord. 2019;7(6):801-7. http://dx.doi.org/10.1016/j.jvsv.2019.03.015. PMid:31196766.

66 Raju S, Walker W, Noel C, Kuykendall R, Powell T, Jayaraj A. Dimensional disparity between duplex and intravascular ultrasound in the assessment of iliac vein stenosis. Vasc Med. 2021;26(5):549-55. http://dx.doi.org/10.1177/1358863X211003663. PMid:33840321.

67 Toh MR, Damodharan K, Lim HHMN, Tang TY. Computed tomography venography versus intravascular ultrasound in the diagnosis of iliofemoral vein stenosis. Vasa. 2021;50(1):38-44. http://dx.doi.org/10.1024/0301-1526/a000920. PMid:33153399.

68 Montminy ML, Thomasson JD, Tanaka GJ, Lamanilao LM, Crim W, Raju S. A comparison between intravascular ultrasound and venography in identifying key parameters essential for iliac vein stenting. J Vasc Surg Venous Lymphat Disord. 2019;7(6):801-7. http://dx.doi.org/10.1016/j.jvsv.2019.03.015. PMid:31196766.

69 Lau I, Png CYM, Eswarappa M, et al. Defining the utility of anteroposterior venography in the diagnosis of venous iliofemoral obstruction. J Vasc Surg Venous Lymphat Disord. 2019;7(4):514-521.e4. http://dx.doi.org/10.1016/j.jvsv.2018.11.012. PMid:30926244.

70 Lorenção de Almeida B, Rossi FH, Guerra de Moraes Rego Sousa A, et al. Correlation between venous pressure gradients and intravascular ultrasound in the diagnosis of iliac vein compression syndrome. J Vasc Surg Venous Lymphat Disord. 2018;6(4):492-9. http://dx.doi.org/10.1016/j.jvsv.2017.11.015. PMid:29526687.

71 Rossi FH, Kambara AM, Rodrigues TO, et al. Comparison of computed tomography venography and intravascular ultrasound in screening and classification of iliac vein obstruction in patients with chronic venous disease. J Vasc Surg Venous Lymphat Disord. 2020;8(3):413-22. http://dx.doi.org/10.1016/j.jvsv.2019.09.015. PMid:32197952.

72 Uhl JF. Three-dimensional modelling of the venous system by direct multislice helical computed tomography venography: technique, indications and results. Phlebology. 2012;27(6):270-88. http://dx.doi.org/10.1258/phleb.2012.012J07. PMid:23155152.

73 Łastowiecka-Moras E. How posture influences venous blood flow in the lower limbs: results of a study using photoplethysmography. Int J Occup Saf Ergon. 2017;23(2):147-51. http://dx.doi.org/10.1080/10803548.2016.1256938. PMid:27813456.

74 Neto FC, de Oliveira RG, Thomazinho F, Weinhardt Batista AP, Moraes Kessler I. Impact of great saphenous vein foam sclerotherapy on quality of life and photoplethysmography findings in chronic venous insufficiency: one-year follow-up. Dermatol Surg. 2020;46(3):369-75. http://dx.doi.org/10.1097/DSS.0000000000002063. PMid:31397782.

75 Liu J, Yan B, Chen SC, Zhang YT, Sodini C, Zhao N. Non-invasive capillary blood pressure measurement enabling early detection and classification of venous congestion. IEEE J Biomed Health Inform. 2021;25(8):2877-86. http://dx.doi.org/10.1109/JBHI.2021.3055760. PMid:33513121.

76 Nelzén POE, Skoog J, Öster M, Zachrisson H. Impact on venous haemodynamics after treatment of great saphenous vein incompetence using plethysmography and duplex ultrasound. Phlebology. 2020;35(7):495-504. http://dx.doi.org/10.1177/0268355519898952. PMid:31959059.

77 Nelzén PO, Skoog J, Lassvik C, Länne T, Zachrisson H. Prediction of post-interventional outcome in great saphenous vein incompetence: the role of venous plethysmography with selective superficial vein occlusion. Eur J Vasc Endovasc Surg. 2016;52(3):377-84. http://dx.doi.org/10.1016/j.ejvs.2016.05.032. PMid:27405879.

78 Rabe E, Ballarini S, Lehr L. A randomized, double-blind, placebo-controlled, clinical study on the efficacy and safety of calcium dobesilate in the treatment of chronic venous insufficiency. Phlebology. 2016;31(4):264-74. http://dx.doi.org/10.1177/0268355515586097. PMid:25991692.

79 Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Syst Rev. 2012;11(11):CD003230. http://dx.doi.org/10.1002/14651858.CD003230.pub4. PMid:23152216.

80 Azhdari M, Zilaee M, Karandish M, et al. Red vine leaf extract (AS 195) can improve some signs and symptoms of chronic venous insufficiency, a systematic review. Phytother Res. 2020;34(10):2577-85. http://dx.doi.org/10.1002/ptr.6705. PMid:32314844.

81 Aziz Z, Tang WL, Chong NJ, Tho LY. A systematic review of the efficacy and tolerability of hydroxyethylrutosides for improvement of the signs and symptoms of chronic venous insufficiency. J Clin Pharm Ther. 2015;40(2):177-85. http://dx.doi.org/10.1111/jcpt.12247. PMid:25630350.

82 Kakkos SK, Allaert FA. Efficacy of Ruscus extract, HMC and vitamin C, constituents of Cyclo 3 fort®, on improving individual venous symptoms and edema: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials. Int Angiol. 2017;36(2):93-106. http://dx.doi.org/10.23736/S0392-9590.17.03815-9. PMid:28225220.

83 Bignamini AA, Matuška J. Sulodexide for the symptoms and signs of chronic venous disease: a systematic review and meta-analysis. Adv Ther. 2020;37(3):1013-33. http://dx.doi.org/10.1007/s12325-020-01232-1. PMid:31989486.

84 Martinez-Zapata MJ, Vernooij RW, Simancas-Racines D, et al. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2020;11(11):CD003229. PMid:33141449.

85 de Lima DC. Varicose veins and occupational health: symptoms, treatment and prevention. Rev Bras Med Trab. 2019;17(4):589-93. http://dx.doi.org/10.5327/Z1679443520190460. PMid:32685759.

86 Kakkos SK, Nicolaides AN. Efficacy of micronized purified flavonoid fraction (Daflon®) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials. Int Angiol. 2018;37(2):143-54. http://dx.doi.org/10.23736/S0392-9590.18.03975-5. PMid:29385792.

87 Kakkos SK, Timpilis M, Patrinos P, et al. Acute effects of graduated elastic compression stockings in patients with symptomatic varicose veins: a randomised double-blind placebo controlled trial. Eur J Vasc Endovasc Surg. 2018;55(1):118-25. http://dx.doi.org/10.1016/j.ejvs.2017.10.004. PMid:29129457.

88 Dahm KT, Myrhaug HT, Strømme H, Fure B, Brurberg KG. Effects of preventive use of compression stockings for elderly with chronic venous insufficiency and swollen legs: a systematic review and meta-analysis. BMC Geriatr. 2019;19(1):76. http://dx.doi.org/10.1186/s12877-019-1087-1. PMid:30845919.

89 Knight Nee Shingler SL, Robertson L, Stewart M. Graduated compression stockings for the initial treatment of varicose veins in people without venous ulceration. Cochrane Database Syst Rev. 2021;7(7):CD008819. PMid:34271595.

90 Schmidt AC, Gomes LPOZ, Marinelli CM, Gomes RZ. Effects of strengthening the surae triceps muscle on venous pump function in chronic venous insufficiency. J Vasc Bras. 2021;20:e20200197. http://dx.doi.org/10.1590/1677-5449.200197. PMid:34456985.

91 Aydin G, Yeldan I, Akgul A, Ipek G. Effects of inspiratory muscle training versus calf muscle training on quality of life, pain, venous function and activity in patients with chronic venous insufficiency. J Vasc Surg Venous Lymphat Disord. 2022;10(5):1137-46. http://dx.doi.org/10.1016/j.jvsv.2022.04.012. PMID: 35710091.

92 Ercan S, Çetin C, Yavuz T, Demir HM, Atalay YB. Effects of isokinetic calf muscle exercise program on muscle strength and venous function in patients with chronic venous insufficiency. Phlebology. 2018;33(4):261-6. http://dx.doi.org/10.1177/0268355517695401. PMid:28954574.

93 Erdal ES, Demirgüç A, Kabalcı M, Demirtaş H. Evaluation of physical activity level and exercise capacity in patients with varicose veins and chronic venous insufficiency. Phlebology. 2021;36(8):636-43. http://dx.doi.org/10.1177/02683555211002339. PMid:33745365.

94 Keser İ, Özdemir K, Erer D, Onurlu İ, Bezgin S. Differences in pain, fatigue, and quality of life in patients with chronic venous insufficiency based on physical activity level. Turk Gogus Kalp Damar Cerrahisi Derg. 2020;28(1):76-83. http://dx.doi.org/10.5606/tgkdc.dergisi.2020.18068. PMid:32175146.

95 Mutlak O, Aslam M, Standfield N. The influence of exercise on ulcer healing in patients with chronic venous insufficiency. Int Angiol. 2018;37(2):160-8. http://dx.doi.org/10.23736/S0392-9590.18.03950-0. PMid:29368880.

96 Silva KLS, Figueiredo EAB, Lopes CP, et al. The impact of exercise training on calf pump function, muscle strength, ankle range of motion, and health-related quality of life in patients with chronic venous insufficiency at different stages of severity: a systematic review. J Vasc Bras. 2021;20:e20200125. http://dx.doi.org/10.1590/1677-5449.200125. PMid:34093685.

97 Kiloatar H, Aras O, Korkmaz M, Vural AH. An evaluation of quality of life, physical activity level and symptoms in patients with early stages of chronic venous disease. J Vasc Nurs. 2021;39(4):108-13. http://dx.doi.org/10.1016/j.jvn.2021.07.007. PMid:34865720.

98 Davies HO, Popplewell M, Singhal R, Smith N, Bradbury AW. Obesity and lower limb venous disease - the epidemic of phlebesity. Phlebology. 2017;32(4):227-33. http://dx.doi.org/10.1177/0268355516649333. PMID: 27178403.

99 Parkyn WR, Chan CY, Van Rij AM. Skin problems in the lower legs of morbidly obese patients and possible role of bariatric surgery. J Obes Weight Loss Ther. 2014;4(4):230. http://dx.doi.org/10.4172/2165-7904.1000230.

100 van Rij AM, De Alwis CS, Jiang P, et al. Obesity and impaired venous function. Eur J Vasc Endovasc Surg. 2008;35(6):739-44. http://dx.doi.org/10.1016/j.ejvs.2008.01.006. PMID: 18313335.

101 Deol ZK, Lakhanpal S, Franzon G, Pappas PJ. Effect of obesity on chronic venous insufficiency treatment outcomes. J Vasc Surg Venous Lymphat Disord. 2020;8(4):617-28.e1. https://doi.org/10.1016/j.jvsv.2020.04.006.

102 Shaalan W, El Emam A, Lotfy H, Naga A. Clinical and hemodynamic outcome of morbidly obese patients with severe chronic venous insufficiency with and without bariatric surgery. J Vasc Surg Venous Lymphat Disord. 2021;9(5):1248-1256.e2. http://dx.doi.org/10.1016/j.jvsv.2021.01.005. PMid:33540136.

103 Meulendijks AM, Franssen WMA, Schoonhoven L, Neumann HAM. A scoping review on chronic venous disease and the development of a venous leg ulcer: the role of obesity and mobility. J Tissue Viability. 2020;29(3):190-6. http://dx.doi.org/10.1016/j.jtv.2019.10.002. PMID: 31668667.

104 Wiewiora M, Piecuch J, Glück M, Slowinska-Lozynska L, Sosada K. Impact of weight loss due to sleeve gastrectomy on shear stress of the femoral vein in morbid obesity. Obes Surg. 2014;24(5):806-12. http://dx.doi.org/10.1007/s11695-013-1175-9. PMid:24421156.

105 Michaels JA, Brazier JE, Campbell WB, MacIntyre JB, Palfreyman SJ, Ratcliffe J. Randomized clinical trial comparing surgery with conservative treatment for uncomplicated varicose veins. Br J Surg. 2006;93(2):175-81. http://dx.doi.org/10.1002/bjs.5264. PMid:16432825.

106 Carradice D, Wallace T, Gohil R, Chetter I. A comparison of the effectiveness of treating those with and without the complications of superficial venous insufficiency. Ann Surg. 2014;260(2):396-401. http://dx.doi.org/10.1097/SLA.0000000000000541. PMid:24424141.

107 Ratcliffe J, Brazier JE, Campbell WB, Palfreyman S, MacIntyre JB, Michaels JA. Cost-effectiveness analysis of surgery versus conservative treatment for uncomplicated varicose veins in a randomized clinical trial. Br J Surg. 2006;93(2):182-6. http://dx.doi.org/10.1002/bjs.5263. PMid:16432810.

108 Marsden G, Perry M, Bradbury A, et al. A Cost-effectiveness analysis of surgery, endothermal ablation, ultrasound-guided foam sclerotherapy and compression stockings for symptomatic varicose veins. Eur J Vasc Endovasc Surg. 2015;50(6):794-801. http://dx.doi.org/10.1016/j.ejvs.2015.07.034. PMid:26433594.

109 Malskat WSJ, Engels LK, Hollestein LM, Nijsten T, van den Bos RR. Commonly used endovenous laser ablation (evla) parameters do not influence efficacy: results of a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2019;58(2):230-42. http://dx.doi.org/10.1016/j.ejvs.2018.10.036. PMid:31230868.

110 Lawson JA, Gauw SA, van Vlijmen CJ, et al. Prospective comparative cohort study evaluating incompetent great saphenous vein closure using radiofrequency-powered segmental ablation or 1470-nm endovenous laser ablation with radial-tip fibers (Varico 2 study). J Vasc Surg Venous Lymphat Disord. 2018;6(1):31-40. http://dx.doi.org/10.1016/j.jvsv.2017.06.016. PMid:29248107.

111 Malskat WSJ, Giang J, De Maeseneer MGR, Nijsten TEC, van den Bos RR. Randomized clinical trial of 940- versus 1470-nm endovenous laser ablation for great saphenous vein incompetence. Br J Surg. 2016;103(3):192-8. http://dx.doi.org/10.1002/bjs.10035. PMid:26661521.

112 Sandhya PA, Mohil RS, Sricharan R. Randomised controlled study to compare radiofrequency ablation with minimally invasive ultrasound-guided non-flush ligation and stripping of great saphenous vein in the treatment of varicose veins. Ann R Coll Surg Engl. 2020;102(7):525-31. http://dx.doi.org/10.1308/rcsann.2020.0116. PMid:32538106.

113 Beteli CB, Rossi FH, de Almeida BL, et al. Prospective, double-blind, randomized controlled trial comparing electrocoagulation and radiofrequency in the treatment of patients with great saphenous vein insufficiency and lower limb varicose veins. J Vasc Surg Venous Lymphat Disord. 2018;6(2):212-9. http://dx.doi.org/10.1016/j.jvsv.2017.09.010. PMid:29229466.

114 Flessenkämper I, Hartmann M, Hartmann K, Stenger D, Roll S. Endovenous laser ablation with and without high ligation compared to high ligation and stripping for treatment of great saphenous varicose veins: Results of a multicentre randomised controlled trial with up to 6 years follow-up. Phlebology. 2016;31(1):23-33. http://dx.doi.org/10.1177/0268355514555547. PMid:25342648.

115 Erzinger FL, de Araujo WJB, Nejm CS, Caron FC, Timi JRR. Estudo comparativo da termoablação da veia safena magna na coxa, com e sem tumescência. J Vasc Bras. 2016;15(3):217-23. http://dx.doi.org/10.1590/1677-5449.004616. PMid:29930593.

116 Paravastu SC, Horne M, Dodd PD. Endovenous ablation therapy (laser or radiofrequency) or foam sclerotherapy versus conventional surgical repair for short saphenous varicose veins. Cochrane Database Syst Rev. 2016;11(11):CD010878. http://dx.doi.org/10.1002/14651858.CD010878.pub2. PMid:27898181.

117 O’Donnell TF, Balk EM, Dermody M, Tangney E, Iafrati MD. Recurrence of varicose veins after endovenous ablation of the great saphenous vein in randomized trials. J Vasc Surg Venous Lymphat Disord. 2016;4(1):97-105. http://dx.doi.org/10.1016/j.jvsv.2014.11.004. PMid:26946904.

118 Darwood RJ, Theivacumar N, Dellagrammaticas D, Mavor AID, Gough MJ. Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins. Br J Surg. 2008;95(3):294-301. http://dx.doi.org/10.1002/bjs.6101. PMid:18278775.

119 Hamann SAS, Giang J, De Maeseneer MGR, Nijsten TEC, van den Bos RR. Editor’s Choice - five year results of great saphenous vein treatment: a meta-analysis. Eur J Vasc Endovasc Surg. 2017;54(6):760-70. http://dx.doi.org/10.1016/j.ejvs.2017.08.034. PMid:29033337.

120 Kheirelseid EAH, Crowe G, Sehgal R, et al. Systematic review and meta-analysis of randomized controlled trials evaluating long-term outcomes of endovenous management of lower extremity varicose veins. J Vasc Surg Venous Lymphat Disord. 2018;6(2):256-70. http://dx.doi.org/10.1016/j.jvsv.2017.10.012. PMid:29292115.

121 Burihan MC. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices. Sao Paulo Med J. 2014;132(1):69. http://dx.doi.org/10.1590/1516-3180.20141321T2. PMid:24474085.

122 Gauw SA, Lawson JA, van Vlijmen-van Keulen CJ, Pronk P, Gaastra MT, Mooij MC. Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia. J Vasc Surg. 2016;63(2):420-8. http://dx.doi.org/10.1016/j.jvs.2015.08.084. PMid:26602795.

123 Sandhya PA, Mohil RS, Sricharan R. Randomised controlled study to compare radiofrequency ablation with minimally invasive ultrasound-guided non-flush ligation and stripping of great saphenous vein in the treatment of varicose veins. Ann R Coll Surg Engl. 2020;102(7):525-31. http://dx.doi.org/10.1308/rcsann.2020.0116. PMid:32538106.

124 Rass K, Frings N, Glowacki P, Gräber S, Tilgen W, Vogt T. Same site recurrence is more frequent after endovenous laser ablation compared with high ligation and stripping of the great saphenous vein: 5 year Results of a Randomized Clinical Trial (RELACS Study). Eur J Vasc Endovasc Surg. 2015;50(5):648-56. http://dx.doi.org/10.1016/j.ejvs.2015.07.020. PMid:26319476.

125 Myers KA, Jolley D, Clough A, Kirwan J. Outcome of ultrasound-guided sclerotherapy for varicose veins: medium-term results assessed by ultrasound surveillance. Eur J Vasc Endovasc Surg. 2007;33(1):116-21. http://dx.doi.org/10.1016/j.ejvs.2006.09.005. PMid:17067832.

126 Watanabe S, Okamura A, Iwamoto M, et al. A randomized controlled trial to evaluate the safety and efficacy of transluminal injection of foam sclerotherapy compared with ultrasound-guided foam sclerotherapy during endovenous catheter ablation in patients with varicose veins. J Vasc Surg Venous Lymphat Disord. 2022;10(1):75-81.e1. http://dx.doi.org/10.1016/j.jvsv.2021.06.017. PMid:34252576.

127 Li X, Yang B, Li X, Ren S. Prospective comparison of effect of ligation and foam sclerotherapy with foam sclerotherapy alone for varicose veins. Ann Vasc Surg. 2018;49:75-9. http://dx.doi.org/10.1016/j.avsg.2018.01.004. PMid:29428536.

128 Darvall KA, Bate GR, Bradbury AW. Patient-reported outcomes 5-8 years after ultrasound-guided foam sclerotherapy for varicose veins. Br J Surg. 2014;101(9):1098-104. http://dx.doi.org/10.1002/bjs.9581. PMid:24962055.

129 van der Velden SK, Biemans AA, De Maeseneer MG, et al. Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins. Br J Surg. 2015;102(10):1184-94. http://dx.doi.org/10.1002/bjs.9867. PMid:26132315.

130 Shadid N, Nelemans P, Lawson J, Sommer A. Predictors of recurrence of great saphenous vein reflux following treatment with ultrasound-guided foam 155sclerotherapy. Phlebology. 2015;30(3):194-9. http://dx.doi.org/10.1177/0268355514521183. PMid:24474721.

131 Silva MAM, Araujo ÁZP, do Amaral JF, de Jesus-Silva SG, Cardoso RS, Miranda F. Júnior. Impacto da escleroterapia com espuma de polidocanol guiada por ultrassom em pacientes com úlcera venosa. J Vasc Bras. 2017;16(3):239-43. http://dx.doi.org/10.1590/1677-5449.002717. PMid:29930653.

132 Marsden G, Perry M, Bradbury A, et al. A cost-effectiveness analysis of surgery, endothermal ablation, ultrasound-guided foam sclerotherapy and compression stockings for symptomatic varicose veins. Eur J Vasc Endovasc Surg. 2015;50(6):794-801. http://dx.doi.org/10.1016/j.ejvs.2015.07.034. PMid:26433594.

133 Lim SY, Tan JX, D’Cruz RT, Syn N, Chong TT, Tang TY. Catheter-directed foam sclerotherapy, an alternative to ultrasound-guided foam sclerotherapy for varicose vein treatment: a systematic review and meta-analysis. Phlebology. 2020;35(6):369-83. http://dx.doi.org/10.1177/0268355519898309. PMid:31918640.

134 Vähäaho S, Halmesmäki K, Mahmoud O, Albäck A, Noronen K, Venermo M. Three-year results of a randomized controlled trial comparing mechanochemical and thermal ablation in the treatment of insufficient great saphenous veins. J Vasc Surg Venous Lymphat Disord. 2021;9(3):652-9. http://dx.doi.org/10.1016/j.jvsv.2020.08.007. PMid:32795619.

135 Holewijn S, van Eekeren RRJP, Vahl A, de Vries JPPM, Reijnen MMPJ, MARADONA study group. Two-year results of a multicenter randomized controlled trial comparing Mechanochemical endovenous Ablation to RADiOfrequeNcy Ablation in the treatment of primary great saphenous vein incompetence (MARADONA trial). J Vasc Surg Venous Lymphat Disord. 2019;7(3):364-74. http://dx.doi.org/10.1016/j.jvsv.2018.12.014. PMid:31000063.

136 Mohamed AH, Leung C, Wallace T, Smith G, Carradice D, Chetter I. A randomized controlled trial of endovenous laser ablation versus mechanochemical ablation with ClariVein in the Management of Superficial Venous Incompetence (LAMA Trial). Ann Surg. 2021;273(6):e188-95. http://dx.doi.org/10.1097/SLA.0000000000003749. PMid:31977509.

137 Vos CG, Ünlü Ç, Bosma J, van Vlijmen CJ, de Nie AJ, Schreve MA. A systematic review and meta-analysis of two novel techniques of nonthermal endovenous ablation of the great saphenous vein. J Vasc Surg Venous Lymphat Disord. 2017;5(6):880-96. http://dx.doi.org/10.1016/j.jvsv.2017.05.022. PMid:29037363.

138 Chen AJ, Ulloa JG, Torrez T, et al. Mechanochemical endovenous ablation of the saphenous vein: a look at contemporary outcomes. Ann Vasc Surg. 2022;82:7-12. http://dx.doi.org/10.1016/j.avsg.2021.11.019. PMid:34933109.

139 Tawfik AM, Sorour WA, El-Laboudy ME. Laser ablation versus mechanochemical ablation in the treatment of primary varicose veins: a randomized clinical trial. J Vasc Surg Venous Lymphat Disord. 2020;8(2):211-5. http://dx.doi.org/10.1016/j.jvsv.2019.10.025. PMid:31864932.

140 Alozai T, Huizing E, Schreve M, et al. A systematic review and meta-analysis of mechanochemical endovenous ablation using Flebogrif for varicose veins. J Vasc Surg Venous Lymphat Disord. 2022;10(1):248-257.e2. http://dx.doi.org/10.1016/j.jvsv.2021.05.010. PMid:34091106.

141 Apruzzi L, Bilman V, Ardita V, et al. Comparison of mechanochemical ablation versus ligation and stripping for the treatment of incompetent small saphenous vein. Phlebology. 2022;37(1):48-54. http://dx.doi.org/10.1177/02683555211045191. PMid:34505545.

142 González Cañas E, Florit López S, Vilagut RV, et al. A randomized controlled noninferiority trial comparing radiofrequency with stripping and conservative hemodynamic cure for venous insufficiency technique for insufficiency of the great saphenous vein. J Vasc Surg Venous Lymphat Disord. 2021;9(1):101-12. http://dx.doi.org/10.1016/j.jvsv.2020.04.019. PMid:32353592.

143 Zmudzinski M, Malo P, Hall C, Hayashi A. CHIVA - a prospective study of a vein sparing technique for the management of varicose vein disease. Am J Surg. 2017;213(5):967-9. http://dx.doi.org/10.1016/j.amjsurg.2017.03.025. PMid:28431588.

144 Onida S, Davies AH. CHIVA, ASVAL and related techniques--concepts and evidence. Phlebology. 2015;30(2, Suppl):42-5. http://dx.doi.org/10.1177/0268355515591439. PMid:26556702.

145 Faccini FP, Ermini S, Franceschi C. CHIVA to treat saphenous vein insufficiency in chronic venous disease: characteristics and results. J Vasc Bras. 2019;18:e20180099. http://dx.doi.org/10.1590/1677-5449.009918. PMid:31191629.

146 Yun S. Ultrasound-based topographic analysis of tributary vein connection with the saphenous vein during ambulatory conservative hemodynamic correction of chronic venous insufficiency. J Vasc Surg Venous Lymphat Disord. 2019;7(3):356-63. http://dx.doi.org/10.1016/j.jvsv.2018.09.011. PMid:30777672.

147 Tenezaca-Sari X, García-Reyes M, Escribano-Ferrer JM, Marrero C, Bellmunt-Montoya S. The CHIVA strategy applied to large-diameter saphenous veins. Int Angiol. 2022;41(4):332-7. http://dx.doi.org/10.23736/S0392-9590.22.04831-3. PMid:35373939.

148 Zolotukhin IA, Seliverstov EI, Zakharova EA, Kirienko AI. Short-term results of isolated phlebectomy with preservation of incompetent great saphenous vein (ASVAL procedure) in primary varicose veins disease. Phlebology. 2017;32(9):601-7. http://dx.doi.org/10.1177/0268355516674415. PMid:27760806.

149 Kuyumcu G, Salazar GM, Prabhakar AM, Ganguli S. Minimally invasive treatments for perforator vein insufficiency. Cardiovasc Diagn Ther. 2016;6(6):593-8. http://dx.doi.org/10.21037/cdt.2016.11.12. PMid:28123979.

150 Gibson K, Elias S, Adelman M, et al. A prospective safety and effectiveness study using endovenous laser ablation with a 400-μm optical fiber for the treatment of pathologic perforator veins in patients with advanced venous disease (SeCure trial). J Vasc Surg Venous Lymphat Disord. 2020;8(5):805-13. http://dx.doi.org/10.1016/j.jvsv.2020.01.014. PMid:32205128.

151 Lawrence PF, Alktaifi A, Rigberg D, DeRubertis B, Gelabert H, Jimenez JC. Endovenous ablation of incompetent perforating veins is effective treatment for recalcitrant venous ulcers. J Vasc Surg. 2011;54(3):737-42. http://dx.doi.org/10.1016/j.jvs.2011.02.068. PMid:21658887.

152 Kishore R, Sankar TB, Anandi A, Nedunchezhian S, Murugan V. A prospective study in comparison of ambulatory phlebectomy and duplex guided foam sclerotherapy in the management of varicosities with isolated perforator incompetence. Indian J Surg. 2016;78(5):356-63. http://dx.doi.org/10.1007/s12262-016-1481-2. PMid:27994330.

153 Schuller-Petrović S, Pavlović MD, Schuller S, Schuller-Lukic B, Adamic M. Telangiectasias resistant to sclerotherapy are commonly connected to a perforating vessel. Phlebology. 2013;28(6):320-3. http://dx.doi.org/10.1258/phleb.2012.012019. PMid:22865418.

154 Aurshina A, Ascher E, Mount L, Hingorani A, Marks N, Hingorani A. Success rate and factors predictive of redo radiofrequency ablation of perforator veins. J Vasc Surg Venous Lymphat Disord. 2018;6(5):621-5. http://dx.doi.org/10.1016/j.jvsv.2018.01.014. PMid:29678685.

155 Ozsvath K, Hager E, Harlander-Locke M, Masuda E, Elias S, Dillavou ED. Current techniques to treat pathologic perforator veins. J Vasc Surg Venous Lymphat Disord. 2017;5(2):293-6. http://dx.doi.org/10.1016/j.jvsv.2016.10.085. PMid:28214499.

156 Hager ES, Washington C, Steinmetz A, Wu T, Singh M, Dillavou E. Factors that influence perforator vein closure rates using radiofrequency ablation, laser ablation, or foam sclerotherapy. J Vasc Surg Venous Lymphat Disord. 2016;4(1):51-6. http://dx.doi.org/10.1016/j.jvsv.2015.08.004. PMid:26946896.

157 Lane TR, Kelleher D, Shepherd AC, Franklin IJ, Davies AH. Ambulatory varicosity avulsion later or synchronized (AVULS): a randomized clinical trial. Ann Surg. 2015;261(4):654-61. http://dx.doi.org/10.1097/SLA.0000000000000790. PMid:24950277.

158 Andrews RH, Dixon RG. Ambulatory Phlebectomy and Sclerotherapy as Tools for the Treatment of Varicose Veins and Telangiectasias. Semin Intervent Radiol. 2021;38(2):160-6. http://dx.doi.org/10.1055/s-0041-1727151. PMid:34108801.

159 Geersen DF, Shortell CEK. Phlebectomy techniques for varicose veins. Surg Clin North Am. 2018;98(2):401-14. http://dx.doi.org/10.1016/j.suc.2017.11.008. PMid:29502780.

160 Hager ES, Ozvath KJ, Dillavou ED. Evidence summary of combined saphenous ablation and treatment of varicosities versus staged phlebectomy. J Vasc Surg Venous Lymphat Disord. 2017;5(1):134-7. http://dx.doi.org/10.1016/j.jvsv.2016.07.009. PMid:27987603.

161 de Roos KP, Nieman FH, Neumann HA. Ambulatory phlebectomy versus compression sclerotherapy: results of a randomized controlled trial. Dermatol Surg. 2003;29(3):221-6. http://dx.doi.org/10.1097/00042728-200303000-00004. PMid:12614412.

162 Harlander-Locke M, Jimenez JC, Lawrence PF, Derubertis BG, Rigberg DA, Gelabert HA. Endovenous ablation with concomitant phlebectomy is a safe and effective method of treatment for symptomatic patients with axial reflux and large incompetent tributaries. J Vasc Surg. 2013;58(1):166-72. http://dx.doi.org/10.1016/j.jvs.2012.12.054. PMid:23571079.

163 Wang JC, Li Y, Li GY, et al. A comparison of concomitant tributary laser ablation and foam sclerotherapy in patients undergoing truncal endovenous laser ablation for lower limb varicose veins. J Vasc Interv Radiol. 2018;29(6):781-9. http://dx.doi.org/10.1016/j.jvir.2018.01.774. PMid:29705225.

164 Müller L, Alm J. Feasibility and technique of endovenous laser ablation (EVLA) of recurrent varicose veins deriving from the sapheno-femoral junction-A case series of 35 consecutive procedures. PLoS One. 2020;15(7):e0235656. http://dx.doi.org/10.1371/journal.pone.0235656. PMid:32628724.

165 Müller L, Alm J. Feasibility and potential significance of prophylactic ablation of the major ascending tributaries in endovenous laser ablation (EVLA) of the great saphenous vein: a case series. PLoS One. 2021;16(1):e0245275. http://dx.doi.org/10.1371/journal.pone.0245275. PMid:33412566.

166 Ashpitel HF, Dabbs EB, Nemchand JL, La Ragione RM, Salguero FJ, Whiteley MS. Histological and immunofluorescent analysis of a large tributary of the great saphenous vein treated with a 1920 nm endovenous laser: preliminary findings. EJVES Short Rep. 2018;39:7-11. http://dx.doi.org/10.1016/j.ejvssr.2018.03.003. PMid:29988869.

167 Myers KA, Clough A, Tilli H. Endovenous laser ablation for major varicose tributaries. Phlebology. 2013;28(4):180-3. http://dx.doi.org/10.1258/phleb.2011.011088. PMid:22490724.

168 Zhang J, Jing Z, Schliephake DE, Otto J, Malouf GM, Gu YQ. Efficacy and safety of Aethoxysklerol® (polidocanol) 0.5%, 1% and 3% in comparison with placebo solution for the treatment of varicose veins of the lower extremities in Chinese patients (ESA-China Study). Phlebology. 2012;27(4):184-90. http://dx.doi.org/10.1258/phleb.2011.010094. PMid:22045827.

169 Vasquez M, Gasparis AP, Varithena® 017 Investigator Group. A multicenter, randomized, placebo-controlled trial of endovenous thermal ablation with or without polidocanol endovenous microfoam treatment in patients with great saphenous vein incompetence and visible varicosities. Phlebology. 2017;32(4):272-81. http://dx.doi.org/10.1177/0268355516637300. PMid:26957489.

170 Miranda LA, do Carmo RC, Sathler-Melo CC, de Castro-Santos G. Bilateral foam polidocanol sclerotherapy of great saphenous veins and their tributaries in synchronous procedure. J Vasc Bras. 2021;20:e20200178. http://dx.doi.org/10.1590/1677-5449.200178. PMid:34211536.

171 Cartee TV, Wirth P, Greene A, et al. Ultrasound-guided foam sclerotherapy is safe and effective in the management of superficial venous insufficiency of the lower extremity. J Vasc Surg Venous Lymphat Disord. 2021;9(4):1031-40. http://dx.doi.org/10.1016/j.jvsv.2021.03.020. PMid:34144767.

172 Lobastov K, Vorontsova A, Bargandzhiya A, et al. The frequency and clinical significance of nontarget superficial and deep vein occlusion after physician compounded foam sclerotherapy of varicose tributaries. Phlebology. 2020;35(6):430-9. http://dx.doi.org/10.1177/0268355519898595. PMid:31924136.

173 Reich-Schupke S, Weyer K, Altmeyer P, Stücker M. Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5% foam. Vasa. 2010;39(2):169-74. http://dx.doi.org/10.1024/0301-1526/a000023. PMid:20464673.

174 Ontas H, Yavuz T, Acar AN, Uysal D. Comparison of ultrasound results following endovenous laser ablation and radiofrequency ablation in the treatment of varicose veins. Ann Ital Chir. 2019;90:457-62. PMid:31661439.

175 Almeida CE. Vascular access: the impact of ultrasonography. Einstein (Sao Paulo). 2016;14(4):561-6. http://dx.doi.org/10.1590/s1679-45082016rw3129. PMid:28076607.

176 Stolz LA, Stolz U, Howe C, Farrell IJ, Adhikari S. Ultrasound-guided peripheral venous access: a meta-analysis and systematic review. J Vasc Access. 2015;16(4):321-6. http://dx.doi.org/10.5301/jva.5000346. PMid:25656255.

177 Gibson K, Gunderson K. Liquid and foam sclerotherapy for spider and varicose veins. Surg Clin North Am. 2018;98(2):415-29. http://dx.doi.org/10.1016/j.suc.2017.11.010. PMid:29502781.

178 Thomson L. Sclerotherapy of telangiectasias or spider veins in the lower limb: a review. J Vasc Nurs. 2016;34(2):61-2. http://dx.doi.org/10.1016/j.jvn.2016.04.002. PMid:27210454.

179 de Ávila Oliveira R, Riera R, Vasconcelos V, Baptista-Silva JC. Injection sclerotherapy for varicose veins. Cochrane Database Syst Rev. 2021;12(12):CD001732. PMid:34883526.

180 Bertanha M, Jaldin RG, Moura R, et al. Sclerotherapy for Reticular Veins in the Lower Limbs: A Triple-Blind Randomized Clinical Trial. JAMA Dermatol. 2017;153(12):1249-55. http://dx.doi.org/10.1001/jamadermatol.2017.3426. PMid:28973414.

181 Bertanha M, Yoshida WB, Bueno de Camargo PA, et al. Polidocanol Plus Glucose Versus Glucose Alone for the Treatment of Telangiectasias: Triple Blind, Randomised Controlled Trial (PG3T). Eur J Vasc Endovasc Surg. 2021;61(1):128-135. http://dx.doi.org/10.1016/j.ejvs.2020.07.007. PMid:32778489.

182 Munia MA, Wolosker N, Munia CG, Chao WS, Puech-Leão P. Comparison of laser versus sclerotherapy in the treatment of lower extremity telangiectases: a prospective study. Dermatol Surg. 2012;38(4):635-9. http://dx.doi.org/10.1111/j.1524-4725.2011.02226.x. PMid:22221551.

183 Parlar B, Blazek C, Cazzaniga S, et al. Treatment of lower extremity telangiectasias in women by foam sclerotherapy vs. Nd:YAG laser: a prospective, comparative, randomized, open-label trial. J Eur Acad Dermatol Venereol. 2015;29(3):549-54. http://dx.doi.org/10.1111/jdv.12627. PMid:25069999.

184 Ianosi G, Ianosi S, Calbureanu-Popescu MX, Tutunaru C, Calina D, Neagoe D. Comparative study in leg telangiectasias treatment with Nd:YAG laser and sclerotherapy. Exp Ther Med. 2019;17(2):1106-12. PMid:30679981.

185 Kaygin MA, Halici U. Evaluation of liquid or foam sclerotherapy in small varicose veins (ceap c1) with venous clinical severity score. Rev Assoc Med Bras. 2018;64(12):1117-21. http://dx.doi.org/10.1590/1806-9282.64.12.1117. PMid:30569988.

186 Bernstein EF, Noyaner-Turley A, Renton B. Treatment of spider veins of the lower extremity with a novel 532 nm KTP laser. Lasers Surg Med. 2014;46(2):81-8. http://dx.doi.org/10.1002/lsm.22178. PMid:24127163.

187 Mujadzic M, Ritter EF, Given KS. A novel approach for the treatment of spider veins. Aesthet Surg J. 2015;35(7):NP221-9. http://dx.doi.org/10.1093/asj/sjv004. PMid:26246022.

188 Gold MH, Biron J, Sensing W. Evaluation of a new diode laser for the treatment of lower extremity leg veins. J Cosmet Dermatol. 2019;18(3):773-7. http://dx.doi.org/10.1111/jocd.12923. PMid:31116009.

189 Meesters AA, Pitassi LH, Campos V, Wolkerstorfer A, Dierickx CC. Transcutaneous laser treatment of leg veins. Lasers Med Sci. 2014;29(2):481-92. http://dx.doi.org/10.1007/s10103-013-1483-2. PMid:24220848.

190 Bush R, Bush P. Histological findings correlated with clinical outcomes in telangiectasia treated with ohmic thermolysis and 940 nm laser. J Cosmet Dermatol. 2018;17(5):779-82. http://dx.doi.org/10.1111/jocd.12761. PMid:30226025.

191 Diken Aİ, Alemdaroğlu U, Özyalçın S, et al. Adjuvant radiofrequency thermocoagulation improves the outcome of liquid sclerotherapy in the treatment of spider veins of the leg: A pilot study. Phlebology. 2021;36(8):620-6. http://dx.doi.org/10.1177/02683555211006534. PMid:33813962.

192 Moreno-Moraga J, Smarandache A, Pascu ML, Royo J, Trelles MA. 1064 nm Nd:YAG long pulse laser after polidocanol microfoam injection dramatically improves the result of leg vein treatment: a randomized controlled trial on 517 legs with a three-year follow-up. Phlebology. 2014;29(10):658-66. http://dx.doi.org/10.1177/0268355513502786. PMid:23989971.

193 Miyake RK, Chi YW, Franklin IJ, Gianesini S. State of the art on cryo-laser cryo-sclerotherapy in lower limb venous aesthetic treatment. J Vasc Surg Venous Lymphat Disord. 2020;8(5):893-5. http://dx.doi.org/10.1016/j.jvsv.2020.01.003. PMid:32179040.

194 Goldman MP, Fitzpatrick RE. Pulsed-dye laser treatment of leg telangiectasia: with and without simultaneous sclerotherapy. J Dermatol Surg Oncol. 1990;16(4):338-44. http://dx.doi.org/10.1111/j.1524-4725.1990.tb00045.x. PMid:2324370.

195 Tan MKH, Salim S, Onida S, Davies AH. Postsclerotherapy compression: a systematic review. J Vasc Surg Venous Lymphat Disord. 2021;9(1):264-74. http://dx.doi.org/10.1016/j.jvsv.2020.07.011. PMid:32791308.

196 Weiss RA, Sadick NS, Goldman MP, Weiss MA. Post-sclerotherapy compression: controlled comparative study of duration of compression and its effects on clinical outcome. Dermatol Surg. 1999;25(2):105-8. http://dx.doi.org/10.1046/j.1524-4725.1999.08180.x. PMid:10037513.

197 Kern P, Ramelet AA, Wütschert R, Hayoz D. Compression after sclerotherapy for telangiectasias and reticular leg veins: a randomized controlled study. J Vasc Surg. 2007;45(6):1212-6. http://dx.doi.org/10.1016/j.jvs.2007.02.039. PMid:17467226.

198 Ivo CS, Ivo MB, Salles PG, Rosário RC, Nunes TA. Effect of the period of extrinsic mechanical compression following sclerotherapy in veins in rabbit ears. Acta Cir Bras. 2011;26(3):165-73. http://dx.doi.org/10.1590/S0102-86502011000300003. PMid:21537517.

199 Bayer A, Kuznik N, Langan EA, et al. Clinical outcome of short-term compression after sclerotherapy for telangiectatic varicose veins. J Vasc Surg Venous Lymphat Disord. 2021;9(2):435-43. http://dx.doi.org/10.1016/j.jvsv.2020.05.015. PMid:32502730.

200 Friedmann DP, Liolios AM, Wu DC, Goldman MP, Eimpunth SA. Randomized, double-blind, placebo-controlled study of the effect of a high-potency topical corticosteroid after sclerotherapy for reticular and telangiectatic veins of the lower extremities. Dermatol Surg. 2015;41(10):1158-63. http://dx.doi.org/10.1097/DSS.0000000000000467. PMid:26359998.

201 Ho D, Jagdeo J, Waldorf HA. Is there a role for arnica and bromelain in prevention of post-procedure ecchymosis or edema? A systematic review of the literature. Dermatol Surg. 2016;42(4):445-63. http://dx.doi.org/10.1097/DSS.0000000000000701. PMid:27035499.

202 Izzo M, Coscia V. Assessment of a topical product based on a mixture of polysulfated galactosaminoglycan in the topical treatment of postoperative blood extravasation (ecchymosis-hematoma) in phlebology. Minerva Med. 2018;109(4):266-75. http://dx.doi.org/10.23736/S0026-4806.18.05642-2. PMid:29696939.

203 de Mello BAS, Beiriz YR, Bonatto AC, Maciel GSB, de Almeida LR, Corassa JM. Use of brimonidine tartrate to resolve telangiectatic matting: case report. J Vasc Bras. 2020;19:e20190159. http://dx.doi.org/10.1590/1677-5449.190159. PMid:34290750.

204 Suggs AK, Macri A, Richmond H, Munavalli G, Friedman PM. Treatment of erythematotelangiectatic rosacea with pulsed-dye laser and oxymetazoline 1.0% cream: a retrospective study. Lasers Surg Med. 2020;52(1):38-43. http://dx.doi.org/10.1002/lsm.23176. PMid:31709571.

205 Deaver Peterson J, Katz TM. Open-label study assessing the efficacy and tolerability of topical skin care and sun protection alone and in combination with intense pulsed light therapy. J Cosmet Dermatol. 2019;18(6):1758-64. http://dx.doi.org/10.1111/jocd.12952. PMid:31017734.

206 Kiguchi MM, Hager ES, Winger DG, Hirsch SA, Chaer RA, Dillavou ED. Factors that influence perforator thrombosis and predict healing with perforator sclerotherapy for venous ulceration without axial reflux. J Vasc Surg. 2014;59(5):1368-76. http://dx.doi.org/10.1016/j.jvs.2013.11.007. PMid:24406088.

207 Masuda EM, Kessler DM, Lurie F, Puggioni A, Kistner RL, Eklof B. The effect of ultrasound-guided sclerotherapy of incompetent perforator veins on venous clinical severity and disability scores. J Vasc Surg. 2006;43(3):551-6, discussion 556-7. http://dx.doi.org/10.1016/j.jvs.2005.11.038. PMid:16520171.
 


Submitted date:
05/11/2023

Accepted date:
08/01/2023

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
654e471aa953951741552464 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections