Treatment of Varicose Veins/Venous Insufficiency Policy (References - Part 2)

Citations and Endnotes

Endnotes: 1) Based on expert opinion. 2) Based on expert opinion.

Ref #	Citation (authors, title, source, year)	PMID / URL when present
{"text":"6","status":""},{"text":"Jones L, Braithwaite BD, Selwyn D, et al. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein. Eur J Vasc Endovasc Surg. Nov 1996; 12(4): 442-5.","status":""},{"text":"PMID 8980434","status":""}
{"text":"7","status":""},{"text":"Rutgers PH, Kitslaar PJ. Randomized trial of stripping versus high ligation combined with sclerotherapy in the treatment of the incompetent greater saphenous vein. Am J Surg. Oct 1994; 168(4): 311-5.","status":""},{"text":"PMID 7943585","status":""}
{"text":"8","status":""},{"text":"Farah MH, Nayfeh T, Urtecho M, et al. A systematic review supporting the Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society guidelines on the management of varicose veins. J Vasc Surg Venous Lymphat Disord. Sep 2022; 10(5): 1155-1171.","status":""},{"text":"PMID 34450355","status":""}
{"text":"9","status":""},{"text":"Whing J, Nandhra S, Nesbitt C, et al. Interventions for great saphenous vein incompetence. Cochrane Database Syst Rev. Aug 11 2021; 8(8): CD005624.","status":""},{"text":"PMID 34378180","status":""}
{"text":"10","status":""},{"text":"Paravastu SC, Horne M, Dodd PD. Endovenous ablation therapy (laser or radiofrequency) or foam sclerotherapy versus conventional surgical repair for short saphenous varicose veins. Cochrane Database Syst Rev. Nov 29 2016; 11(11): CD010878.","status":""},{"text":"PMID 27898181","status":""}
{"text":"11","status":""},{"text":"Brittenden J, Cotton SC, Elders A, et al. A randomized trial comparing treatments for varicose veins. N Engl J Med. Sep 25 2014; 371(13): 1218-27.","status":""},{"text":"PMID 25251616","status":""}
{"text":"12","status":""},{"text":"Rass K, Frings N, Glowacki P, et al. Comparable effectiveness of endovenous laser ablation and high ligation with stripping of the great saphenous vein: two-year results of a randomized clinical trial (RELACS study). Arch Dermatol. Jan 2012; 148(1): 49-58.","status":""},{"text":"PMID 21931012","status":""}
{"text":"13","status":""},{"text":"Rass K, Frings N, Glowacki P, et al. Same Site Recurrence is More Frequent After Endovenous Laser Ablation Compared with High Ligation and Stripping of the Great Saphenous Vein: 5 year Results of a Randomized Clinical Trial (RELACS Study). Eur J Vasc Endovasc Surg. Nov 2015; 50(5): 648-56.","status":""},{"text":"PMID 26319476","status":""}
{"text":"14","status":""},{"text":"Christenson JT, Gueddi S, Gemayel G, et al. Prospective randomized trial comparing endovenous laser ablation and surgery for treatment of primary great saphenous varicose veins with a 2-year follow-up. J Vasc Surg. Nov 2010; 52(5): 1234-41.","status":""},{"text":"PMID 20801608","status":""}
{"text":"15","status":""},{"text":"Biemans AA, Kockaert M, Akkersdijk GP, et al. Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg. Sep 2013; 58(3): 727-34.e1.","status":""},{"text":"PMID 23769603","status":""}
{"text":"16","status":""},{"text":"van der Velden SK, Biemans AA, De Maeseneer MG, et al. Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins. Br J Surg. Sep 2015; 102(10): 1184-94.","status":""},{"text":"PMID 26132315","status":""}
{"text":"17","status":""},{"text":"Wallace T, El-Sheikha J, Nandhra S, et al. Long-term outcomes of endovenous laser ablation and conventional surgery for great saphenous varicose veins. Br J Surg. Dec 2018; 105(13): 1759-1767.","status":""},{"text":"PMID 30132797","status":""}
{"text":"18","status":""},{"text":"Alozai T, Huizing E, Schreve MA, et al. A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency. Phlebology. Apr 2022; 37(3): 165-179.","status":""},{"text":"PMID 34965757","status":""}
{"text":"19","status":""},{"text":"Hamann SAS, Giang J, De Maeseneer MGR, et al. Editor's Choice - Five Year Results of Great Saphenous Vein Treatment: A Meta-analysis. Eur J Vasc Endovasc Surg. Dec 2017; 54(6): 760-770.","status":""},{"text":"PMID 29033337","status":""}
{"text":"20","status":""},{"text":"Vähäaho S, Mahmoud O, Halmesmäki K, et al. Randomized clinical trial of mechanochemical and endovenous thermal ablation of great saphenous varicose veins. Br J Surg. Apr 2019; 106(5): 548-554.","status":""},{"text":"PMID 30908611","status":""}
{"text":"21","status":""},{"text":"Hamel-Desnos C, Nyamekye I, Chauzat B, et al. FOVELASS: A Randomised Trial of Endovenous Laser Ablation Versus Polidocanol Foam for Small Saphenous Vein Incompetence. Eur J Vasc Endovasc Surg. Mar 2023; 65(3): 415-423.","status":""},{"text":"PMID 36470312","status":""}
{"text":"22","status":""},{"text":"Shadid N, Ceulen R, Nelemans P, et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg. Aug 2012; 99(8): 1062-70.","status":""},{"text":"PMID 22627969","status":""}
{"text":"23","status":""},{"text":"Lam YL, Lawson JA, Toonder IM, et al. Eight-year follow-up of a randomized clinical trial comparing ultrasound-guided foam sclerotherapy with surgical stripping of the great saphenous vein. Br J Surg. May 2018; 105(6): 692-698.","status":""},{"text":"PMID 29652081","status":""}
{"text":"24","status":""},{"text":"U.S. Food and Drug Administration, Center for Drug Evaluation and Research. Summary Review: 205098 Varithena. 2013; https://www.accessdata.fda.gov/drugsatfda_docs/nda/2013/205098Orig1s000SumR.pdf.","status":""},{"text":"URL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2013/205098Orig1s000SumR.pdf (Accessed March 18, 2025)","status":""}
{"text":"25","status":""},{"text":"Todd KL, Wright DI, Gibson K, et al. The VANISH-2 study: a randomized, blinded, multicenter study to evaluate the efficacy and safety of polidocanol endovenous microfoam 0.5% and 1.0% compared with placebo for the treatment of saphenofemoral junction incompetence. Phlebology. Oct 2014; 29(9): 60818.","status":""},{"text":"PMID 23864535","status":""}
{"text":"26","status":""},{"text":"Vasquez M, Gasparis AP. A multicenter, randomized, placebo-controlled trial of endovenous thermal ablation with or without polidocanol endovenous microfoam treatment in patients with great saphenous vein incompetence and visible varicosities. Phlebology. May 2017; 32(4): 272-281.","status":""},{"text":"PMID 26957489","status":""}
{"text":"27","status":""},{"text":"Watanabe S, Okamura A, Iwamoto M, et al. A randomized controlled study to evaluate the safety and feasibility of concomitant transluminal injection of foam sclerosant combined with endovenous laser ablation in patients with incompetent small saphenous veins. Phlebology. Mar 2025; 40(2): 116-125.","status":""},{"text":"PMID 39209827","status":""}
{"text":"28","status":""},{"text":"Deak ST. Retrograde administration of ultrasound-guided endovenous microfoam chemical ablation for the treatment of superficial venous insufficiency. J Vasc Surg Venous Lymphat Disord. Jul 2018; 6(4): 477-484.","status":""},{"text":"PMID 29909854","status":""}
{"text":"29","status":""},{"text":"Bootun R, Lane TR, Dharmarajah B, et al. Intra-procedural pain score in a randomised controlled trial comparing mechanochemical ablation to radiofrequency ablation: The Multicentre Venefit ™ versus ClariVein® for varicose veins trial. Phlebology. Feb 2016; 31(1): 61-5.","status":""},{"text":"PMID 25193822","status":""}
{"text":"30","status":""},{"text":"Lane T, Bootun R, Dharmarajah B, et al. A multi-centre randomised controlled trial comparing radiofrequency and mechanical occlusion chemically assisted ablation of varicose veins - Final results of the Venefit versus Clarivein for varicose veins trial. Phlebology. Mar 2017; 32(2): 89-98.","status":""},{"text":"PMID 27221810","status":""}
{"text":"31","status":""},{"text":"Lam YL, Toonder IM, Wittens CH. Clarivein® mechano-chemical ablation an interim analysis of a randomized controlled trial dose-finding study. Phlebology. Apr 2016; 31(3): 170-6.","status":""},{"text":"PMID 26249150","status":""}
{"text":"32","status":""},{"text":"Holewijn S, van Eekeren RRJP, Vahl A, et al. Two-year results of a multicenter randomized controlled trial comparing Mechanochemical endovenous Ablation to RADiOfrequeNcy Ablation in the treatment of primary great saphenous vein incompetence (MARADONA trial). J Vasc Surg Venous Lymphat Disord. May 2019; 7(3): 364-374.","status":""},{"text":"PMID 31000063","status":""}
{"text":"33","status":""},{"text":"Mohamed AH, Leung C, Wallace T, et al. A Randomized Controlled Trial of Endovenous Laser Ablation Versus Mechanochemical Ablation With ClariVein in the Management of Superficial Venous Incompetence (LAMA Trial). Ann Surg. Jun 01 2021; 273(6): e188-e195.","status":""},{"text":"PMID 31977509","status":""}
{"text":"34","status":""},{"text":"Oud S, Alozai T, Lam YL, et al. Long-term outcomes of mechanochemical ablation using the Clarivein device for the treatment of great saphenous vein incompetence. J Vasc Surg Venous Lymphat Disord. Jan 2025; 13(1): 101967.","status":""},{"text":"PMID 39270843","status":""}
{"text":"35","status":""},{"text":"Thierens N, Holewijn S, Vissers WH, et al. Five-year outcomes of mechano-chemical ablation of primary great saphenous vein incompetence. Phlebology. May 2020; 35(4): 255-261.","status":""},{"text":"PMID 31291849","status":""}
{"text":"36","status":""},{"text":"U.S. Food and Drug Administration. VenaSeal Closure System. PMA P140018. 2015; https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P140018.","status":""},{"text":"URL https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P140018 (Accessed March 18, 2025)","status":""}
{"text":"37","status":""},{"text":"Morrison N, Gibson K, McEnroe S, et al. Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg. Apr 2015; 61(4): 985-94.","status":""},{"text":"PMID 25650040","status":""}
{"text":"38","status":""},{"text":"Gibson K, Ferris B. Cyanoacrylate closure of incompetent great, small and accessory saphenous veins without the use of post-procedure compression: Initial outcomes of a post-market evaluation of the VenaSeal System (the WAVES Study). Vascular. Apr 2017; 25(2): 149-156.","status":""},{"text":"PMID 27206470","status":""}
{"text":"39","status":""},{"text":"Klem TM, Schnater JM, Schütte PR, et al. A randomized trial of cryo stripping versus conventional stripping of the great saphenous vein. J Vasc Surg. Feb 2009; 49(2): 403-9.","status":""},{"text":"PMID 19028042","status":""}
{"text":"40","status":""},{"text":"Gibson K, Khilnani N, Schul M, et al. American College of Phlebology Guidelines - Treatment of refluxing accessory saphenous veins. Phlebology. Aug 2017; 32(7): 448-452.","status":""},{"text":"PMID 27738240","status":""}
{"text":"41","status":""},{"text":"Morrison N, Kolluri R, Vasquez M, et al. Comparison of cyanoacrylate closure and radiofrequency ablation for the treatment of incompetent great saphenous veins: 36-Month outcomes of the VeClose randomized controlled trial. Phlebology. Jul 2019; 34(6): 380-390.","status":""},{"text":"PMID 30403154","status":""}
{"text":"42","status":""},{"text":"Eroglu E, Yasim A. A Randomised Clinical Trial Comparing N-Butyl Cyanoacrylate, Radiofrequency Ablation and Endovenous Laser Ablation for the Treatment of Superficial Venous Incompetence: Two Year follow up Results. Eur J Vasc Endovasc Surg. Oct 2018; 56(4): 553-560.","status":""},{"text":"PMID 30042039","status":""}
{"text":"43","status":""},{"text":"Alhewy MA, Abdo EM, Ghazala EAE, et al. Outcomes of Cyanoacrylate Closure Versus Radiofrequency Ablation for the Treatment of Incompetent Great Saphenous Veins. Ann Vasc Surg. Jan 2024; 98: 309-316.","status":""},{"text":"PMID 37802141","status":""}
{"text":"44","status":""},{"text":"Morrison N, Gibson K, Vasquez M, et al. VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins. J Vasc Surg Venous Lymphat Disord. May 2017; 5(3): 321-330.","status":""},{"text":"PMID 28411697","status":""}
{"text":"45","status":""},{"text":"Eroglu E, Yasim A, Ari M, et al. Mid-term results in the treatment of varicose veins with N-butyl cyanoacrylate. Phlebology. Dec 2017; 32(10): 665-669.","status":""},{"text":"PMID 28669248","status":""}
{"text":"46","status":""},{"text":"Zierau U. Sealing Veins with the VenaSeal Sapheon Closure System: Results for 795 Treated Truncal Veins after 1000 Days. Vasomed. 2015;27:124-127.","status":""},{"text":"","status":""}
{"text":"47","status":""},{"text":"Imai T, Mo M, Hirokawa M, et al. Mid-term results of cyanoacrylate closure for the treatment of incompetent great and small saphenous veins: Findings from a Japanese prospective consecutive multi-center registry: Mid-term results of cyanoacrylate closure. Phlebology. Feb 2025; 40(1): 21-28.","status":""},{"text":"PMID 39116289","status":""}
{"text":"48","status":""},{"text":"Disselhoff BC, der Kinderen DJ, Kelder JC, et al. Randomized clinical trial comparing endovenous laser with cryostripping for great saphenous varicose veins. Br J Surg. Oct 2008; 95(10): 1232-8.","status":""},{"text":"PMID 18763255","status":""}
{"text":"49","status":""},{"text":"Disselhoff BC, der Kinderen DJ, Kelder JC, et al. Five-year results of a randomized clinical trial comparing endovenous laser ablation with cryostripping for great saphenous varicose veins. Br J Surg. Aug 2011; 98(8): 1107-11.","status":""},{"text":"PMID 21633948","status":""}
{"text":"50","status":""},{"text":"de Ávila Oliveira R, Riera R, Vasconcelos V, et al. Injection sclerotherapy for varicose veins. Cochrane Database Syst Rev. Dec 10 2021; 12(12): CD001732.","status":""},{"text":"PMID 34883526","status":""}
{"text":"51","status":""},{"text":"Leopardi D, Hoggan BL, Fitridge RA, et al. Systematic review of treatments for varicose veins. Ann Vasc Surg. Mar 2009; 23(2): 264-76.","status":""},{"text":"PMID 19059756","status":""}
{"text":"52","status":""},{"text":"ElSheikha J, Nandhra S, Carradice D, et al. Clinical outcomes and quality of life 5 years after a randomized trial of concomitant or sequential phlebectomy following endovenous laser ablation for varicose veins. Br J Surg. Aug 2014; 101(9): 1093-7.","status":""},{"text":"PMID 24916467","status":""}
{"text":"53","status":""},{"text":"Yamaki T, Hamahata A, Soejima K, et al. Prospective randomised comparative study of visual foam sclerotherapy alone or in combination with ultrasound-guided foam sclerotherapy for treatment of superficial venous insufficiency: preliminary report. Eur J Vasc Endovasc Surg. Mar 2012; 43(3): 3437.","status":""},{"text":"PMID 22230599","status":""}
{"text":"54","status":""},{"text":"Michaels JA, Campbell WB, Brazier JE, et al. Randomised clinical trial, observational study and assessment of cost-effectiveness of the treatment of varicose veins (REACTIV trial). Health Technol Assess. Apr 2006; 10(13): 1-196, iii-iv.","status":""},{"text":"PMID 16707070","status":""}
{"text":"55","status":""},{"text":"Luebke T, Brunkwall J. Meta-analysis of transilluminated powered phlebectomy for superficial varicosities. J Cardiovasc Surg (Torino). Dec 2008; 49(6): 757-64.","status":""},{"text":"PMID 19043390","status":""}
{"text":"56","status":""},{"text":"Chetter IC, Mylankal KJ, Hughes H, et al. Randomized clinical trial comparing multiple stab incision phlebectomy and transilluminated powered phlebectomy for varicose veins. Br J Surg. Feb 2006; 93(2): 169-74.","status":""},{"text":"PMID 16432820","status":""}
{"text":"57","status":""},{"text":"Giannopoulos S, Rodriguez L, Chau M, et al. A systematic review of the outcomes of percutaneous treatment modalities for pathologic saphenous and perforating veins. J Vasc Surg Venous Lymphat Disord. Sep 2022; 10(5): 1172-1183.e5.","status":""},{"text":"PMID 35364302","status":""}
{"text":"58","status":""},{"text":"Ho VT, Adkar SS, Harris EJ. Systematic review and meta-analysis of management of incompetent perforators in patients with chronic venous insufficiency. J Vasc Surg Venous Lymphat Disord. Jul 2022; 10(4): 955-964.e5.","status":""},{"text":"PMID 35217217","status":""}
{"text":"59","status":""},{"text":"Tenbrook JA, Iafrati MD, O'donnell TF, et al. Systematic review of outcomes after surgical management of venous disease incorporating subfascial endoscopic perforator surgery. J Vasc Surg. Mar 2004; 39(3): 583-9.","status":""},{"text":"PMID 14981453","status":""}
{"text":"60","status":""},{"text":"van Gent WB, Catarinella FS, Lam YL, et al. Conservative versus surgical treatment of venous leg ulcers: 10-year follow up of a randomized, multicenter trial. Phlebology. Mar 2015; 30(1 Suppl): 35-41.","status":""},{"text":"PMID 25729066","status":""}
{"text":"61","status":""},{"text":"Blomgren L, Johansson G, Dahlberg-Akerman A, et al. Changes in superficial and perforating vein reflux after varicose vein surgery. J Vasc Surg. Aug 2005; 42(2): 315-20.","status":""},{"text":"PMID 16102633","status":""}
{"text":"62","status":""},{"text":"Lin ZC, Loveland PM, Johnston RV, et al. Subfascial endoscopic perforator surgery (SEPS) for treating venous leg ulcers. Cochrane Database Syst Rev. Mar 03 2019; 3(3): CD012164.","status":""},{"text":"PMID 30827037","status":""}
{"text":"63","status":""},{"text":"Luebke T, Brunkwall J. Meta-analysis of subfascial endoscopic perforator vein surgery (SEPS) for chronic venous insufficiency. Phlebology. Feb 2009; 24(1): 8-16.","status":""},{"text":"PMID 19155335","status":""}
{"text":"64","status":""},{"text":"Lawrence PF, Hager ES, Harlander-Locke MP, et al. Treatment of superficial and perforator reflux and deep venous stenosis improves healing of chronic venous leg ulcers. J Vasc Surg Venous Lymphat Disord. Jul 2020; 8(4): 601-609.","status":""},{"text":"PMID 32089497","status":""}
{"text":"65","status":""},{"text":"Masuda E, Ozsvath K, Vossler J, et al. The 2020 appropriate use criteria for chronic lower extremity venous disease of the American Venous Forum, the Society for Vascular Surgery, the American Vein and Lymphatic Society, and the Society of Interventional Radiology. J Vasc Surg Venous Lymphat Disord. Jul 2020; 8(4): 505-525.e4.","status":""},{"text":"PMID 32139328","status":""}
{"text":"66","status":""},{"text":"Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. May 2011; 53(5 Suppl): 2S-48S.","status":""},{"text":"PMID 21536172","status":""}
{"text":"67","status":""},{"text":"Gloviczki P, Lawrence PF, Wasan SM, et al. The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part I. Duplex Scanning and Treatment of Superficial Truncal Reflux: Endorsed by the Society for Vascular Medicine and the International Union of Phlebology. J Vasc Surg Venous Lymphat Disord. Mar 2023; 11(2): 231-261.e6.","status":""},{"text":"PMID 36326210","status":""}
{"text":"68","status":""},{"text":"Gloviczki P, Lawrence PF, Wasan SM, et al. The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II: Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine. J Vasc Surg Venous Lymphat Disord. Jan 2024; 12(1): 101670.","status":""},{"text":"PMID 37652254","status":""}
{"text":"69","status":""},{"text":"American College of Phlebology. Superficial venous disease. 2015; https://www.myavls.org/assets/pdf/SuperficialVenousDiseaseGuidelinesPMS313-02.03.16.pdf.","status":""},{"text":"URL https://www.myavls.org/assets/pdf/SuperficialVenousDiseaseGuidelinesPMS313-02.03.16.pdf (Accessed March 18, 2025)","status":""}
{"text":"70","status":""},{"text":"Blebea J, Fukaya E, Moore KS, et al. Mechanochemical chemically assisted ablation of varicose veins for venous insufficiency: American vein and lymphatic society position statement. Phlebology. Mar 2025; 40(2): 104-109.","status":""},{"text":"PMID 39167828","status":""}
{"text":"71","status":""},{"text":"Brittenden J, Cotton SC, Elders A, et al. Clinical effectiveness and cost-effectiveness of foam sclerotherapy, endovenous laser ablation and surgery for varicose veins: results from the Comparison of LAser, Surgery and foam Sclerotherapy (CLASS) randomised controlled trial. Health Technol Assess. Apr 2015; 19(27): 1-342.","status":""},{"text":"PMID 25858333","status":""}

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Treatment of Varicose Veins/Venous Insufficiency Policy (References - Part 2)

References: Treatment of Varicose Veins / Venous Insufficiency (Part 2)

Citations and Endnotes

Evidence Types and Context

Actionable Notes for Providers

Document Changes