The following interventional/surgical venous therapies (level of evidence: III/B) can be performed in the presence of venous leg ulcer:
- In varicosis (varicose veins), postthrombotic syndrome (PTS) – removal of insufficient vein segments using the following procedures:
- Surgical removal
- Sclerosing (sclerosing) procedures (laser, foam sclerosing/chemical substances).
- Venous valve reconstruction/transplantation
- Ulcer excision (peeling), ulcer debridement (wound cleansing).
- Paratibial fasciotomy (fascia splitting) – to reduce pressures in muscle ligaments; if further therapy fails.
Further notes
- Early endovascular therapy, ie, the use of sclerosing procedures, accelerates healing of venous leg ulcers: in the first year after study entry, participants were free of ulcers for a total of 306 days after early treatment versus 278 days after delayed treatment (hazard ratio for healing of skin lesions of 1.38 (1.13 to 1.68)).
