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AN OVERVIEW OF VARICOSE VEINS SURGICAL MANAGEMENT

1Sarah Ahmed Hasan Alshalan, 1Rawabi Mohammad Abdulhadi Alamri, 2Mona Kadhem Saleh Al Hameed

In this review we discuss the difference between surgical methods, advantages and disadvantages of each for the improvement of treatment methods of varicose. We searched MEDLINE, Embase, Current Contents, Cochrane, PubMed, and the reference section of included articles. Eligible studies compared two or more of the available surgical treatments of varicose veins for all studies published up to 2018 in English language and human subject. It is questionable to do surgical procedure on patients who have recovered from the superficial phlebitis, due to the fact that the dilated varicose veins usually vanished without additional medical therapy. It is not indicated to carry out thrombectomy for superficial thrombosis in great saphenous veins. The patients should be enlightened prior to surgery that varicose vein surgical procedure is not curative, and early surgical treatment in uncomplicated blood vessels will certainly not stop the development of future varicosities. The contraindications for medical management of varicose veins are occlusion of the deep venous system, such as acute deep vein thrombosis (DVT), pregnancy, the surface blood vessels as collaterals for occluded deep veins, and arterial insufficiency; nonetheless, one ought to proceed with caution in carrying out surgery on patients with postthrombotic syndrome, venous refluxing combined with arterial venous fistula, or venous malformation- further imaging to assess the patency of the deep blood vessels is crucial before surgical procedure.

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