Percutaneous Management of Varicose Veins

Abstract Chronic venous disease is a common condition affecting a large proportion of patients and leads to heaviness, aching, swelling, throbbing, and itching in the legs. On the extreme end, this condition can lead to lipodermatosclerosis and ulceration. Appropriate assessment of these patients with Doppler ultrasound is necessary to assess for superficial venous insufficiency and/or deep venous obstruction. Saphenous vein ablation utilizing thermal techniques such as endovenous laser ablation or radiofrequency ablation has proved effective for venous closure and reduction of venous hypertension with a low incidence of complications. Nonthermal, nontumescent options including cyanoacrylate closure (VenaSeal), mechanochemical ablation (ClariVein), and chemical ablation (Varithena) for saphenous vein closure are becoming more frequently used with high rates of effectiveness. This chapter reviews indications for treatment, technical procedural details, and potential complications of varicose vein management.