This protocol applies to patients with chronic venous insufficiency in whom a full course of conservative management has not produced sufficient improvement. It outlines the structured next step when the goals of conservative care have not been met.
Conservative therapy — including compression garments (bandages, stockings, Velcro wrap devices, or pumps), venotonic medications, lifestyle changes, and weight loss where applicable — did not achieve the goals of reduced leg discomfort, reduced edema volume, or improved quality of life. Failure to reach these targets is the trigger for escalation to this protocol.
When conservative measures have not delivered adequate symptom relief, this protocol addresses whether interventional alternatives to compression therapy may be appropriate. The full selection criteria, specific options, and decision framework are available through the link below.
DOI: 10.1016/j.jscai.2025.103729
Some patients who value more rapid resolution of symptoms and are less concerned with potential complications may prefer interventional alternatives to compression therapy such as sclerotherapy, phlebectomy, or ablation if appropriate.
View source ↗