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TITLE:

SURGERY VARICOSE VEINS- RISK FACTOR AND MANAGEMENT

AUTHORS:

Awaji Qasim Alnaami , Abdulrahman Awaji Alna’ami , Ahmad Hassan Hussain Alhazmi , Mohamed Kheder Abdullah Alzahrani , Sultan Ahmed M. Alburayk , Ahmed Abdulrahman Alharbi , Saad Abdullah Saad Albattal Almutairi , Abdulrahman Waleed Bagar , Abdulaziz Ibrahim Alhuthayli , Faisal Musaad Fahad AlRasheed , Khalid Mohsin Almaghribi , Ibrahim Abdulmajeed Affan

ABSTRACT:

Introduction: Varicose vein is considered one of the common diseases that affect a momentous number of population and worsen the quality of their lives (QoL). surgical treatment of superficial venous incompetence was considered the mainstay of intervention. This surgical method is inspired from the early works far away back to 1550 BC when monographs of venous disease and their surgical treatment appear, that Celcus, in first century Rome, suggest the concept of ligation and division of bleeding varicosities, and in the second century, Galen presented ligation and vein avulsion by using specific hooks. however, currently these surgical methods are clearly drawbacks due to the new endovenous thermal ablation method, by using radiofrequency ablation (RFA), endovenous laser ablation (EVLA), furthermore the use of foam sclerotherapy which has been improved recently. Even The National Institute of Health and Clinical Excellence (NICE) guidelines (United Kingdom) on the management of varicose veins recommend endothermal ablation as the first option to consider, transferring surgery only to a third-line alternative. Although the new endothermal methods are reachable, the best choice for long-term management of varicose veins and guarantee the best outcomes is still in doubt. Aim of work: In this review, we will discuss Surgery varicose veins- risk factor and management Methodology: We searched PubMed (http://www.ncbi.nlm.nih.gov/) and Google Scholar (https://scholar.google.com). using search terms: Surgery, varicose veins, risk factor, and management. For Surgery varicose veins- risk factor and management .We just included the full articles and all relevant studies were retrieved and discussed. Conclusions: Surgical treatment for varicose veins is a proven intervention providing good anatomic success and instantaneous elimination of the cause of superficial incompetence. On the other hand, defect in its results clinically and in QoL scores also with slower improvement noted, made its use contracted, furthermore, it often results in a delay recovery period, and lead to serious complications. They proved that the cost of surgical intervention is also less cost-effective treatment option compared to the endovenous methods. The choice of varicose vein treatment to use in current practice is dictated by its cost-effectiveness, thereby, making surgery increasingly harder to justify. Even though surgery still effective method to treat venous incompetence, improve its outcomes can be achieved by doing some modifications on the technique and hopefully make it a more cost-viable alternative. Hence, endovenous ablation, most specifically endothermal methods, will be around for the foreseeable future, unless the newer non-thermal, nontumescent (NTNT) methods prove to be more advantageous. Key words: Surgery, varicose, veins- risk factor, and management.

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