ABSTRACT
Treatment for superficial venous disease is contraindicated if there is deep vein obstruction, but can be effective in reducing venous load if there is deep venous reflux. Endovenous interventions are preferred for recurrent varicose veins, and redo varicose vein surgery is no longer recommended, as results are poor and risk of wound and other complications, such as nerve and lymphatic damage, is high. The American Heart Association recommends that patients with high-risk heart conditions, prosthetic heart valves and prosthetic joints should receive an anti-staphylococcal agent such as cephalothin prior to a procedure, but there are no guidelines for venous procedures. Enquire as to calcium-channel blockers which may be a cause of peripheral oedema in addition to or instead of venous disease. Symptoms tend to be more severe in the early stages of disease, and the presence and severity of symptoms do not correlate well with the size and extent of varicose veins or development of complications.
