The recently published evidence-based Guidelines of the Society for Vascular Surgery and the American Venous Forum1 has been in response to meet the needs of the new paradigm shift in the management of varicose vein disease.

The new era of "minimally invasive technologies" has now progressed into the management of Varicose Veins so that the newer techniques of Endovenous Laser or Radiofrequency Ablation and Ultrasound Guided Sclerotherapy have largely replaced open surgery and stripping.

The German Society of Phlebology2 and the Venous Forum of the Royal Society of Medicine3 have also issued guidelines that there is sufficient evidence to use the minimally invasive technique of Ultrasound Guided Foam Sclerotherapy instead of surgery.


1. Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011;53(Suppl):2S–48S

2. Rabe E, Pannier F. Sclerotherapy of varicose veins with polidocanol based on the guidelines of the German Society of Phlebology. Dermatol Surg 2010;36(Suppl 2): 968–75

3. Berridge D, Bradbury AW, Davies AH, et al. Recommendations for the referral and treatment of patients with lower limb chronic venous insufficiency (including varicose veins). Phlebology 2011;26:91–3

AuthorNicholas Kemp