Description
A variety of treatment modalities are available to treat varicose veins/venous insufficiency, including surgical approaches, thermal ablation, and sclerotherapy. The application of each of these treatment options is influenced by the severity of the symptoms, type of vein, source of venous reflux, and the use of other (prior or concurrent) treatments.
Echosclerotherapy is a technique used for perforator veins. Duplex ultrasound guidance is used to inject a sclerosing agent into varicose veins.
The following are the medical definitions for the terms in this Medical Policy under the section of
:
Treatment Session:
- A treatment session (visit) includes the treatment provided on the SAME day to one (1) or more veins in the SAME leg.
VEIN ANATOMY
- Main Veins:
Greater Saphenous Vein (GSV) , Superficial Saphenous Vein/ Long Saphenous Vein (SSV/LSV)
- Accessory Veins:
Anterior saphenous, Anterior Circumflex, Anterior BranchLateral saphenous, Posterior Circumflex, Posterior medial branch
- Tributary Veins:
smaller branches of all of the above listed veins
- Perforator Veins:
Cockett's, Boyd's, Dodd's, Hunter's, May's, Kuster's
- Telangiectasia/Reticular Veins:
Spider Veins (considered cosmetic)
COMMON ABBREVIATIONS:
- CFV
- Common Femoral Vein: normal
- PFV
- Proximal Femoral Vein
- MFV
- Mid Femoral Vein
- DFV
- Distal Femoral Vein: positive compress
- Pop V
- Popliteal Vein: normal
- SFJ
- Saphenofemoral Junction: normal
- AAGSV
- Anterior Accessory Great Saphenous Vein
- PAGSV
- Posterior Accessory Great Saphenous Vein
- PGSV
- Proximal Great Saphenous Vein
- MGSV
- Mid Great Saphenous Vein
- AAGSV Calf
- Anterior Accessory Great Saphenous Vein Calf
- PAGSV Calf
- Posterior Accessory Great Saphenous Vein Calf
- SPJ
- Saphenopopliteal Junction
- PSSV
- Proximal Small Saphenous Vein
- MSSV
- Mid Small Saphenous Vein
- TESSV
- Thigh Extension Small Saphenous Vein
The standard classification of venous disease is the
CEAP (Clinical, Etiologic, Anatomic, Pathophysiologic) classification system
.
Class | Definition |
C
0 | No visible or palpable signs of venous disease |
C
1 | Telangiectasies or reticular veins |
C
2 | Varicose veins |
C
2r | Recurrent varicose veins |
C
3 | Edema |
C
4 | Changes in skin and subcutaneous tissue secondary to cardiovascular disease (CVD) |
C
4a | Pigmentation and eczema |
C
4b | Lipodermatosclerosis or atrophie blanche |
C
4C | Corona phlebectatica |
C
5 | Healed |
C
6 | Active venous ulcer |
C
6r | Recurrent active venous ulcer |
S | Symptomatic |
A | Asymptomatic |
