Choosing a treatment
Stripping is recommended when there is an inversion of the blood flow in a very enlarged internal or external saphenous vein. Surgery is then the best option. If there is no inversion and blood flows normally from the feet to the heart, surgery is not indicated.
Ambulatory phlebectomy is a technique used primarily for tributaries of the internal or external saphenous veins, when the affected veins are large and flow backwards. It is done separately or as a complement to stripping, or when varicose veins relapse after surgery.
Sclerotherapy is indicated in the treatment of varicose veins without excessive enlargement or major reflux. It is also recommended as a complement to surgery for best results and to avoid relapses. Sclerotherapy is the treatment of choice not only for cosmetic results but also to prevent further vein damage. Simple to do and virtually painless, sclerotherapy nevertheless requires a precise strategy. It must be done by a trained doctor familiar with duplex scanning, a prerequisite before starting treatment.
As a conclusion, these different treatment methods are not mutually exclusive but rather complementary on a case-by-case basis. The choice depends on the data coming from the clinical exam and duplex scanning, and on the awareness of all the possibilities offered by modern technology,
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