Vein Institute and Pain Centers of America, New York, NY, USA.
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Curr Pain Headache Rep. 2019 Mar 4;23(3):16. doi: 10.1007/s11916-019-0759-z.
Chronic venous disease (CVD), although affecting up to 40% of the US population, is often underdiagnosed by healthcare professionals due to an incomplete understanding of the presenting symptoms. CVD is a common cause of lower extremity pain and discomfort, including aching, cramping, tingling, burning, swelling, heaviness, restlessness, and fatigue, and may lead to significant morbidity if left untreated. The negative impact of CVD on quality of life is well established and the optimization of management strategies is an important area of evolving research.
Management of CVD has rapidly evolved over the last two decades with the development of minimally invasive endovenous ablative techniques, now the mainstay of treatment. We discuss the data supporting various methods of CVD treatment with an emphasis on the impact on patient comfort and quality of life. Both radiofrequency ablation (RFA) and endovenous laser therapy (EVLA) are excellent options for treatment of lower extremity venous disease, but RFA is associated with less post-procedure discomfort. Ultrasound-guided foam therapy is best reserved for the adjuvant setting or for patients ineligible for RFA or EVLA.
慢性静脉疾病（CVD）虽然影响了高达 40%的美国人口，但由于对其临床表现的理解不完整，医疗保健专业人员往往对其诊断不足。CVD 是下肢疼痛和不适的常见原因，包括疼痛、痉挛、刺痛、烧灼感、肿胀、沉重感、不安和疲劳，如果不治疗，可能会导致严重的发病率。CVD 对生活质量的负面影响已得到充分证实，优化管理策略是一个不断发展的研究领域。
过去二十年来，随着微创静脉内消融技术的发展，CVD 的治疗迅速发展，现在是治疗的主要手段。我们讨论了支持各种 CVD 治疗方法的数据，重点是对患者舒适度和生活质量的影响。射频消融（RFA）和静脉内激光治疗（EVLA）都是治疗下肢静脉疾病的极好选择，但 RFA 与术后不适的相关性较低。超声引导下泡沫疗法最好保留在辅助治疗环境中，或用于不适合 RFA 或 EVLA 的患者。
