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Doppler ultrasound, treatment and follow up should be done by the same center
VARICOSE VEIN MANAGEMENT: PAST, TODAY AND FUTURE
Varicose vein management underwent some revolutionary developments in the early 2000s. During these years, the incompetent veins that cause varicose veins were successfully treated with endovenous laser ablation by Dr Min and Dr Navarro for the first time. This nonsurgical method was adopted very rapidly particularly in interventional radiology community and were distributed throughout the world. In the same year, a laser-like ablation method called radiofrequency was also used to close the incompetent vein in patients with varicose veins and has also been very successful.
These methods have been developed as an alternative to classical surgical operations (Ligation & stripping, SEPS, etc.) which may have significant risks and complications, have a long return to normal life and leave permanent scars on the skin. The aim of these new treatments is to destroy the incompetent veins that lead to varicose veins without surgery, by burning the vein inside the body. The destroyed vein will be immediately closed and it will start shrinking like a healing wound. In several months, the vein will be completely resolved by the body's natural healing mechanism, so much so that it will not be seen even on ultrasound
Although new methods of treatment were initially met with resistance by surgeons who perform classical surgery, studies have proven the advantages of endovenous laser and radiofrequency over the old treatments. As a result, the classical surgery has been largely replaced by nonsurgical endovenous techniques all over the world.
After laser and radiofrequency, other methods for sealing the leaking vessels such as steam, MOCA and Glue have also been developed. These methods are simpler to implement and have good clinical outcomes. However, their long-term results are unknown there is still some skepticism regarding the safety and durability of these techniques.