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SCAI Technical Review on Management of Chronic Venous Disease
Robert Attaran1, Matthew Edwards2, Matthew C Bunte3
1Yale Heart and Vascular Center, Yale School of Medicine, New Haven, Connecticut.
Journal of the Society for Cardiovascular Angiography & Interventions
|September 29, 2025
Summary
This review found compression therapy likely improves venous ulcer healing. Ablation may help symptoms and healing for ulcer disease, but evidence for other treatments is uncertain.
Area of Science:
- Vascular Medicine
- Interventional Cardiology
- Health Services Research
Background:
- Chronic venous disease (CVD) affects millions, causing leg discomfort, edema, and ulceration, impacting quality of life (QoL).
- Treatment options for CVD range from conservative compression therapy to invasive procedures like ablation, sclerotherapy, phlebectomy, venoplasty, and stenting.
Purpose of the Study:
- To systematically review evidence addressing key questions on chronic venous disease (CVD) management.
- To inform the Society for Cardiovascular Angiography & Interventions (SCAI) Guideline on CVD management.
Main Methods:
- A systematic review of medical literature (2008-2023) was performed using PubMed, Embase, and Cochrane.
- Patient, Intervention, Comparator, Outcome (PICO) format guided question formulation.
- Evidence certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
Main Results:
- Compression therapy likely accelerates and improves venous ulcer healing compared to no compression.
- Great saphenous vein ablation may enhance healing rates and symptom relief for ulcer disease.
- Evidence for other interventions like perforator ablation, venoplasty, stenting, sclerotherapy, and phlebectomy shows high uncertainty regarding outcomes.
Conclusions:
- Findings will guide the SCAI Guideline for Chronic Venous Disease management.
- Research priorities were identified in areas with limited or uncertain evidence.
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