Algorithm to Select the Treatment Modality for the Incompetent Saphenous Vein

Area of Science:

• Vascular Surgery
• Phlebology

Background:

• Saphenous vein reflux is commonly treated with surgical stripping (SS) or endovenous therapies (EVTs).
• EVTs, including thermal and non-thermal ablation, have become the preferred approach due to their minimally invasive nature.

Purpose of the Study:

• To compare the clinical outcomes of SS and EVTs for treating incompetent saphenous veins.
• To propose a decision-making process for selecting the optimal treatment based on vein anatomy and procedure characteristics.

Main Methods:

• Review of clinical outcomes comparing surgical stripping (SS) and endovenous therapies (EVTs).
• Analysis of advantages and disadvantages of each treatment modality.
• Consideration of anatomical features and procedural characteristics for treatment selection.

Main Results:

• Both SS and EVTs demonstrate comparable effectiveness and high closure rates for varicose veins.
• SS offers complete vein removal but has higher risks of surgical complications.
• EVTs provide quicker recovery but have specific risks like thermal injury or thrombophlebitis.

Conclusions:

• Optimal treatment selection for incompetent saphenous veins requires careful consideration of individual patient anatomy and procedure-specific risks.
• EVTs are generally preferred for their minimally invasive nature and faster recovery.
• A structured decision-making process can guide clinicians in choosing between SS and EVTs.