Strategies to Treat Venous Reflux Disease

An estimated 30% of adults in the United States have some degree of venous reflux disease. These may range from subclinical reflux to aesthetic asymptomatic varicosities noted in the superficial tissue to advanced chronic venous disease (CVD) with ulcerations and pain. Given the variety of presentations of patients with venous reflux disease, CVD can be classified using the revised CEAP classification system and/or by using the revised Venous Clinical Severity Score (VCSS). Various treatment modalities are available, including nonoperative and operative management. This chapter focuses on the various modalities available for use and the risks and benefits of each modality and discusses some controversial topics in venous reflux disease. At a minimum, clinical follow-up should include CEAP classification and VCSS scores.