Management of varicose veins: a survey of current practice by members of the Vascular Society of Great Britain and Ireland

INTRODUCTION In 1999, a survey was published detailing the management of varicose veins by members of the then Vascular Surgical-society (VSS); Since then newer methods for treating varicose veins have been developed and far more explicit rationing has been introduced in the NHS. SUBJECTS AND METHODS In order to examine whether there had been a significant change in established practice in the UK, a Society of Great Britain and Ireland (VSGBI) members in the 2004 yearbook by E-mail or post. RESULTS Of the 4216 questionnaires distributed, a 69% response rate was achieved. Of respondents, 97% treated varicose veins in their NHS practice whilst 88% did so in private practice. Some 73% used hand-held Doppler assessment in the clinic, and 96% used duplex ultrasound assessment selectively. Despite UK National Institute for Health and Clinical Excellence (NICE) guideliness, only 68% said that their primary care trusts funded treatment of symptomatic varicose veins, while 93% did so for complications. In either NHS or private practice, respectively, 83% or 72% of responders offered surgery as preferred treatment for primary varicose veins, while 14% or 20% preferred endovascular treatments (endovascular laser treatment, radiofrequency abiation and foam sclerotherapy). Of responders, 17% did not follow-up patients after treatment. CONCLUSIONS This survey suggests there is rationing of access to care for symptomatic varicose veins. Despite publicity for endovenous techniques, surgery remains the preferred treatment for varicose veins in the UK.