In the field of phlebology, the management of varicose veins has seen significant advancements over the past 20 years, with the introduction of endothermal treatment, particularly endovenous laser therapy.

These techniques, recognized for their effectiveness and safety, are governed by numerous international guidelines.

We offer you a focus on the recommendations from the ESVS (European Society for Vascular Surgery), the latest European guideline.

In this most recent version of the recommendations, the ESVS updates the set of guidelines aimed at standardizing and optimizing the use of endothermal treatments (and endovenous laser therapy) in the treatment of varicose veins.

These recommendations are the result of collaboration between experts and clinicians, based on the latest available scientific evidence. They provide precise indications regarding patient selection criteria, treatment protocols, and post-operative measures, thus offering a clear roadmap for practitioners striving for excellence in the management of venous insufficiency.

2022 International Guidelines

Thermal treatments are recommended as first-line therapy

EUROPE

USA

Focus on the indications:

GSV – Class I
“For patients with great saphenous vein incompetence requiring treatment, endovenous thermal ablation is recommended as first choice treatment, in preference to high ligation/stripping and ultrasound guided foam sclerotherapy.”

SSV – Class I (new)
“For patients with great saphenous vein incompetence requiring treatment, endovenous thermal ablation is recommended as first choice treatment, in preference to high ligation/stripping and ultrasound guided foam sclerotherapy.”

Anterior Accessory Saphenous Vein – Class IIa (new)
“For patients with incompetence of the anterior accessory saphenous vein requiring treatment, endovenous thermal ablation should be considered.”

Perforating Veins – Class IIa (new)
“For patients with chronic venous disease requiring treatment of incompetent perforating veins, endovenous ablation, division or ligation should be considered.”

Big vein diameter – Class IIa (new)
“For patients with an incompetent great saphenous vein with a very large truncal diameter (more than 12 mm), endovenous thermal ablation should be considered.”

* ESVS Clinical Guidelines on the management of Chronic Venous Deseases of the lower limb
* Local regulation may apply

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