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Mar 2026
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Varicose Veins

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1. Arshadbhat 30 Mar 2026
  
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  Venoactive drugs (diosmin, hesperidin, horse chestnut seed extract) may be considered as adjuncts to compression for symptomatic relief in countries where available
  
  Vein diameter: Thermal ablation (EVLA or RFA) is preferred for large veins >10 mm in diameter, as nonthermal techniques show lower success rates in this population. [5] Conversely, veins <2 mm may not be suitable for some thermal ablation devices. [6] Vein location and depth: Veins located <0.5 cm from the skin surface have increased risk of thermal injury with traditional thermal ablation. [5] For these superficial veins, nonthermal techniques (cyanoacrylate, mechanochemical ablation) or miniphlebectomy/limited stripping are preferred. [5] Below-knee reflux: Patients with below-knee GSV reflux benefit from ablation to the lowest point of reflux, but nonthermal techniques are preferred to avoid thermal nerve injury.
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Vein diameter: Thermal ablation (EVLA or RFA) is preferred for large veins >10 mm in diameter, as nonthermal techniques show lower success rates in this population. [5] Conversely, veins <2 mm may not be suitable for some thermal ablation devices. [6] Vein location and depth: Veins located <0.5 cm from the skin surface have increased risk of thermal injury with traditional thermal ablation. [5] For these superficial veins, nonthermal techniques (cyanoacrylate, mechanochemical ablation) or miniphlebectomy/limited stripping are preferred. [5] Below-knee reflux: Patients with below-knee GSV reflux benefit from ablation to the lowest point of reflux, but nonthermal techniques are preferred to avoid thermal nerve injury.

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