[Varicose veins of lower limbs: progress in the surgical management]

Varicose veins are part of the spectrum of Chronic Venous Disease. They are very prevalent, especially among women and involve mainly the great saphenous vein.Pathogenesis of varicose veins is complex and multifactorial. There is a valvular incompetence as well as a dilation in the vein wall. However, the sequence in which these mechanisms occur is unknown. Probably the valves become incompetent secondary to vein wall abnormalities.The first description of the surgical technique used today came in the transition from the nineteenth to the twentieth century. In the last decade, the great debate evolved around the new techniques of endovascular radiofrequency and laser ablation. These follow the global trend of Medicine to use less invasive techniques.This study, besides performing a contextualization and review of concepts about varicose veins, especially intends to launch the latest data on the state-of-the-art regarding the treatment of this disease, and stands on data collected from Pubmed.It gets clear that endovascular techniques are safe and effective, besides revealing better results in terms of postoperative morbidity when compared with classic surgery. However, the last decade was marked by constant improvements in techniques, creating difficulties in interpreting data presented in trials. Furthermore, there is progressively greater difficulty in randomizing patients, given their preference for less invasive procedures over traditional surgery. New trials on the long-term efficacy in addition to detailed analysis of costs will also be crucial for the implementation of these new methods.