One-step or step-by-step approaches to varicose veins treatment: timing, method, rationale

BACKGROUND: One of the most contentious issues within the field of phlebology is determining the best approach for correcting varicose tributaries following truncal ablation. Which strategy yields the highest effectiveness remains a subject of debate. Currently, there is a lack of substantial data regarding the selection of treatment strategies based on the diameter of varicose tributaries. Hence, the comparison between staged and one step treatment for varicose veins is a pertinent concern in contemporary phlebology. Conducting research in this area will enable the identification of the benefits and potential drawbacks associated with each proposed tactic.METHODS: The study involved a prospective analysis of 295 patients with varicose veins who received outpatient treatment as part of a combined therapy approach.RESULTS: Performing simultaneous endovenous laser ablation (EVLA) of saphenous trunks and ligation (gentle phlebectomy) of visibly large-diameter tributaries (6 mm or more), followed by staged sclerotherapy after a month, offers substantial potential advantages.CONCLUSIONS: Employing step-by-step treatment for varicose veins helps to reduce the level of traumatic intervention and discomfort experienced by the patient, all the while achieving satisfactory treatment outcomes without compromising the individual’s quality of life.