Strategies and challenges in treatment of varicose veins and venous insufficiency

Table 1 Strategies for management of varicose veins

Name of treatment	Mechanism
Conservative
Medicine	Enhancing venous tone and reducing inflammation
Compression	External pressure, bandages, or graduated stockings
Surgery
HL/S	Ligation of the conjunction of reflux, stripping veins
AP	Removal of veins via small incision
CHIVA	Ligation of the escape point and preserving veins
HIPP	Destroying veins and sucking out with vaccum pressure
Thermal
EVLA	Sealing the veins by laser energy
RFA	Sealing the veins by radiofrequency
Nontheramal
Sclerotherapy	Destroying the venous wall by sclerosants or chemical agents and sealing veins by external pressure
MOCA	Rotating the venous wall and sealing veins with a clue
CAE	Sealing veins with a clue

HL/S: High ligation and stripping; EVLA: Endovenous laser ablation; RFA: Radiofrequency ablation; MOCA: Mechanochemical ablation; CAE: Cyanoacrylate embolization; CHIVA: Cure conservatrice et Hemodynamique de l'Insufficience Veineuse en Ambulatoire.