Markus Stücker1, Eike Sebastian Debus2, Johannes Hoffmann3, Michael Jünger4, Knut Kröger5, Achim Mumme6, Albert-Adrien Ramelet7, Eberhard Rabe8. 1. Department of Dermatology and Allergology, and Center for Venous Disorders of the Departments of Dermatology and Vascular Surgery, Ruhr University Bochum, Bochum, Germany. 2. Department of Vascular Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 3. Department of Vascular Surgery and Phlebology at the Contilia Cardiovascular Center, Elisabeth Hospital Essen, and Division of Vascular Surgery, University Hospital Essen, Essen, Germany. 4. Department of Dermatology, University Medicine Greifswald, Greifswald, Germany. 5. Division of Angiology, Department of Vascular Medicine, HELIOS Medical Center Krefeld, Krefeld, Germany. 6. Department of Vascular Surgery, and Center for Venous Disorders of the Departments of Dermatology and Vascular Surgery, Ruhr University Bochum, Bochum, Germany. 7. Department of Dermatology, Inselspital Bern, Bern, Switzerland. 8. Department of Dermatology and Allergology, Bonn, Germany, University of Bonn, Bonn, Germany.
Abstract
BACKGROUND: Chronic venous diseases are very common. Early symptoms such as a sensation of swelling and heaviness may occur without objectifiable findings, but are nevertheless perceived as bothersome. Progressive disease - marked by varicose veins and symptoms of chronic venous insufficiency - is associated with considerable impairment in quality of life. METHODS: The present consensus recommendations are based on publications in Pubmed-listed journals as well as relevant international therapeutic guidelines on chronic venous diseases. Only conclusive randomized controlled trials (RCTs) and review articles/meta-analyses were included. RESULTS: Symptom-based treatment of chronic venous diseases is based on three therapeutic pillars with proven efficacy: invasive therapy, compression therapy, and oral pharmacological treatment. According to current therapeutic guidelines, invasive procedures aimed at restoring unimpaired venous blood flow as well as improving or eliminating pathological changes should be the first-line approach. If an invasive approach is infeasible or undesirable, or if symptoms persist following a therapeutic intervention, optimal use of symptom-based treatment options is recommended. Compression and pharmacological therapy may each be used as sole treatment or in combination. To guarantee maximum therapeutic success, individual treatment decisions should be made on a case-by-case basis. CONCLUSIONS: Chronic venous diseases should be treated on the basis of individual pathophysiological disturbances. Symptom-based treatment of chronic venous disorders encompasses invasive therapy, compression therapy, and oral pharmacological therapy. Considerations in choosing the appropriate treatment option should include both objective signs as well as subjective symptoms.
BACKGROUND:Chronic venous diseases are very common. Early symptoms such as a sensation of swelling and heaviness may occur without objectifiable findings, but are nevertheless perceived as bothersome. Progressive disease - marked by varicose veins and symptoms of chronic venous insufficiency - is associated with considerable impairment in quality of life. METHODS: The present consensus recommendations are based on publications in Pubmed-listed journals as well as relevant international therapeutic guidelines on chronic venous diseases. Only conclusive randomized controlled trials (RCTs) and review articles/meta-analyses were included. RESULTS: Symptom-based treatment of chronic venous diseases is based on three therapeutic pillars with proven efficacy: invasive therapy, compression therapy, and oral pharmacological treatment. According to current therapeutic guidelines, invasive procedures aimed at restoring unimpaired venous blood flow as well as improving or eliminating pathological changes should be the first-line approach. If an invasive approach is infeasible or undesirable, or if symptoms persist following a therapeutic intervention, optimal use of symptom-based treatment options is recommended. Compression and pharmacological therapy may each be used as sole treatment or in combination. To guarantee maximum therapeutic success, individual treatment decisions should be made on a case-by-case basis. CONCLUSIONS:Chronic venous diseases should be treated on the basis of individual pathophysiological disturbances. Symptom-based treatment of chronic venous disorders encompasses invasive therapy, compression therapy, and oral pharmacological therapy. Considerations in choosing the appropriate treatment option should include both objective signs as well as subjective symptoms.
Authors: J Dissemond; S Eder; S Läuchli; H Partsch; M Stücker; W Vanscheidt Journal: Med Klin Intensivmed Notfmed Date: 2017-01-11 Impact factor: 0.840
Authors: F Pannier; T Noppeney; J Alm; F X Breu; G Bruning; I Flessenkämper; H Gerlach; K Hartmann; B Kahle; H Kluess; E Mendoza; D Mühlberger; A Mumme; H Nüllen; K Rass; S Reich-Schupke; D Stenger; M Stücker; C G Schmedt; T Schwarz; J Tesmann; J Teßarek; S Werth; E Valesky Journal: Hautarzt Date: 2022-04-19 Impact factor: 1.198