Varicose Vein Surgery Guidelines

Updated: Oct 04, 2019
  • Author: Wesley K Lew, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Guidelines

AVF/SVS/ACP/SVM/IUP Guidelines for Compression After Invasive Treatment of Lower-Extremity Superficial Veins

In 2019, clinical practice guidelines for the use of compression therapy after invasive treatment of superficial veins of the lower extremities were published by the American Venous Forum (AVF), the Society for Vascular Surgery (SVS), the American College of Phlebology (ACP), the Society for Vascular Medicine (SVM), and the International Union of Phlebology (IUP). [38] Recommendations included the following:

  • When possible, compression (elastic stockings or wraps) is suggested after surgical or thermal procedures to eliminate varicose veins. 
  • If compression dressings are to be used postprocedurally in patients undergoing ablation or surgical procedures on the saphenous veins, those providing pressures >20 mm Hg together with eccentric pads placed directly over the vein ablated or operated on provide the greatest reduction in postoperative pain.
  • In the absence of convincing evidence, best clinical judgment is recommended to determine the duration of compression therapy after treatment. 
  • Compression therapy is suggested immediately after treatment of superficial veins with sclerotherapy to improve outcomes of sclerotherapy. 
  • In the absence of convincing evidence, best clinical judgment is recommended to determine the duration of compression therapy after sclerotherapy. 
  • In a patient with a venous leg ulcer, compression therapy is recommended over no compression therapy to increase venous leg ulcer healing rate and to decrease the risk of ulcer recurrence. 
  • In a patient with a venous leg ulcer and underlying arterial disease, it is suggested to limit the use of compression to patients with an ankle-brachial index (ABI) exceeding 0.5 or cases where absolute ankle pressure is >60 mm Hg.