关键词: 慢性静脉功能不全, 浅静脉反流, 腔内热闭合术

Abstract: Standardized diagnosis and treatment of chronic venous insufficiency in the lower extremities        WANG Shen-ming, WANG Si-wen. Department of Vascular Surgery, the First Affiliated Hospital of Sun Yat- sen University, Guangzhou 510080, China
Corresponding author: WANG Shen-ming,E-mail:wshenm@mail.sysu.edu.cn
Abstract    Chronic venous insufficiency (CVI) in the lower extremities is one of the most prevalent peripheral vascular diseases. Due to its diverse clinical manifestations and the complexity of pathophysiological changes, the available treatment options are extensive, leading to non-standardized diagnosis and management. Therefore, there is an urgent demand to standardize the diagnosis and treatment of CVI. Firstly, emphasis should be placed on the accurate diagnosis of CVI using the CEAP classification and related methods such as color Doppler ultrasound. Secondly, upon confirming the diagnosis, careful consideration should be given to selecting appropriate treatment methods. The primary treatment for CVI is the management of superficial venous insufficiency. Among various treatment modalities, endovenous thermal closure is the first-line choice for treating CVI, but attention must be paid to heat-related complications. Due to the advantages of no heat-related perioperative complications, novel non-thermal, non-expansile techniques may become important and effective methods for treating CVI in the future. Sclerotherapy and venous pressure therapy are important auxiliary methods, but consideration must always be given to serious complications associated with sclerotherapy, such as the occurrence of thrombosis and pulmonary embolism. Treatment of communicating veins and deep veins is major area of research and discussion in CVI, requiring more rigorous clinical evidence to guide therapy.

Key words: chronic venous insufficiency, superficial venous reflux, endovascular thermal closure