Anticoagulation and interventional treatment of varicose veins

Venous thromboembolic risk is very low after varicose vein procedures. This risk is often cited as less than 1%; however, studies also show the risk to be highly variable. Overall, literature in the field does not typically conclude thromboprophylaxis to be necessary in low-risk patients, owing to the low incidence of the event studied and the often-insufficient number of patients included. Despite the low incidence, venous thromboembolic risk is important in terms of mortality and morbidity. Varicose veins affect an average of 1 in 3 individuals, and there is still great variability in practices concerning thromboprophylaxis throughout the world. The parallel must also be considered with regard to interventional treatment of varicose veins in patients already receiving anticoagulant therapy. Endovenous treatment of varicose veins of the lower limbs has taken precedence over conventional surgery more or less rapidly depending on the country and the level of health care reimbursement. Recommendations advocate for an endovenous rather than a surgical approach whenever possible. However, questions remain unanswered, and a standardization of practices through clear recommendations needs to be drawn.