Treatment Of Chronic Venous Disorder: A Comprehensive Review.

BACKGROUND Chronic Venous Disorder (CVD) is highly prevalent vascular disorder affecting up to 45% of the general population, with clinical manifestations ranging from teleangiectasias to venous leg ulcers (VLUs). OBJECTIVE We examined the currently available data in order to provide an updated, comprehensive review on treatment options of CVD. METHODS We searched MEDLINE, Cochrane, Scopus, EMBASE, ClinicalTrials and OpenGrey databases for relevant articles in English published until November 2020. CONCLUSIONS Compression treatment is the mainstay of conservative treatment. Pharmacological treatment can provide significant symptomatic relief and hence it should be considered as part of conservative treament. Transcutaneous Lacer treatment (TCL) is an effective alternative option to sclerotherapy for treatment of C1 stage. Interventional treatment of saphenous insufficiency should not be withholded in favor of conservative treatment when indications for intervention are present. High ligation and stripping (HL/S), ultrasound-guided foam sclerotherepy (UGFS), endovenous thermal ablation (EVTA) systems and non thermal non tumescent ablation (NTNT) systems are safe and efficacious first-line options for treatment of saphenous insufficiency. Interventional treatment of co-existing incompetent perforator veins (IPVs) is not recommended by contemporary evidence. Regarding deep venous insufficiency (DVI), treatment of symptomatic femoroiliocaval occlussive venous disease refractory to conservative treatment with percutaneous transluminal venoplasty stenting produced encouraging results.