The treatement of lower limb varicose veins:the situation in Italy in 2005

In this review we will show the results of a study based a questionnaire about the “Treatment of lower limb varicose disease” administered to several members of the Italian Society of Cardiovascular and Endovascular Surgery SICVE (Società Italiana di Chirurgia Cardiovascolare ed Endovascolare). This project has been organized by the Indipendent Section of Flebology SAF (Sezione Autonoma di Flebologia) refering to SICVE, founded in 2003 and then repealed in 2007. 41 answers have been collected, some of them directly by e-mail, others during the IV National Congress SICVE (L’Aquila 2005), with various kind of Reference Centres for every surgeon that has answered. These are the most important results obtained from the data analysis: the complete stripping of the safena magna vein from the malleolus to inguen associated to the crossectomy, represents the reference therapeutic gold standard (29 positive answers) with an incidence for single centre from 25 to 100% of the treated cases. The crossectomy is however the fundamental step (37 positive answers). Regarding the operations considered alternative, there was been a preference for thermo-obliteration through the use of laser or radiofrequency (carried out from 66% of the surgeons interviewed) respect to the emodinamic treatment (71% of the clinicians have declared to not have recourse to it). The SEPS is used by an adequate number of surgeons (15 on 41) with an incidence from 0.5% to 20% (~5.6%). About the half of the surgeons interviewed regularly recourses to the post-operating sclerotherapy, reserving it to one fourth of the patients. The preoperating Eco-Doppler is included in the standard evaluation about generally accepted, despite 8 surgeons interviewed have declared to not have recourse to it in every case. In the end, about the nosocomial typology, it has been found a subdivision between ordinary recovery, DH and surgery DH (one night recovery), with a certain preference for this modality