NICE: The National Institute for Health and Care Excellence (UK) last month released guidelines for the diagnosis and management of varicose veins.

These guidelines provide further support that firstly Endothermal Ablation and secondly Ultrasound Guided Foam Sclerotherapy are the recommended techniques of removing varicose veins. Surgical stripping of varicose veins should only be considered if these techniques are NOT suitable. 

The relevant guidelines are to be found on page 10.  

Interventional treatment
1.3.2 For people with confirmed varicose veins and truncal reflux:

  • Offer endothermal ablation (see Radiofrequency ablation of varicose veins [NICE interventional procedure guidance 8] and Endovenous laser treatment of the long saphenous vein [NICE interventional procedure guidance 52]).
  • If endothermal ablation is unsuitable, offer ultrasound-guided foam sclerotherapy (see Ultrasound-guided foam sclerotherapy for varicose veins [NICE interventional procedure guidance 440]).
  • If ultrasound-guided foam sclerotherapy is unsuitable, offer surgery.
AuthorNicholas Kemp