Treatment
18
Operative/Endovascular Management
Superficial Venous Reflux and Active Venous Leg Ulcer–
Ulcer Healing
➤ In a patient with a venous leg ulcer (C6) and incompetent superficial
veins that have axial reflux directed to the bed of the ulcer, we suggest
ablation of the incompetent veins in addition to standard compressive
therapy to improve ulcer healing. (2-C)
Superficial Venous Reflux and Active Venous Leg Ulcer–
Prevent Recurrence
➤ In a patient with a venous leg ulcer (C6) and incompetent superficial
veins that have axial reflux directed to the bed of the ulcer, we
recommend ablation of the incompetent veins in addition to standard
compressive therapy to prevent recurrence. (1-B)
Superficial Venous Reflux and Healed Venous Leg Ulcer
➤ In a patient with a healed venous leg ulcer (C5) and incompetent
superficial veins that have axial reflux directed to the bed of the
ulcer, we recommend ablation of the incompetent veins in addition to
standard compressive therapy to prevent recurrence. (1-C)
Superficial Venous Reflux With Skin Changes at Risk for Venous
Leg Ulcer (C4b)
➤ In a patient with skin changes at risk for venous leg ulcer (C4b) and
incompetent superficial veins that have axial reflux directed to the
bed of the affected skin, we suggest ablation of the incompetent
superficial veins in addition to standard compressive therapy to
prevent ulceration. (2-C)
Combined Superficial and Perforator Venous Reflux With or
Without Deep Venous Reflux and Active Venous Leg Ulcer
➤ In a patient with a venous leg ulcer (C6) and incompetent superficial
veins that have reflux to the ulcer bed in addition to pathologic
perforating veins (outward flow of 500 ms duration, with a diameter of
3.5 mm) located beneath or associated with the ulcer bed, we suggest
ablation of both the incompetent superficial veins and perforator
veins in addition to standard compressive therapy to aid in ulcer
healing and to prevent recurrence. (2-C)
