Innovative Approaches and Future Directions in the Management and Understanding of Varicose Veins: A Systematic Review

Abstract

Varicose veins, a prevalent condition that primarily affects the lower limbs, present significant hurdles in diagnosis and treatment due to their diverse causes. This study dives into the complex hormonal, environmental, and molecular elements that influence varicose vein genesis, emphasizing the need for precise diagnostic methods and changing therapy approaches to improve patient outcomes. It investigates the epidemiology and demographic distribution of varicose veins, delves into their pathophysiology, and assesses diagnostic methods such as duplex ultrasonography and the CEAP classification system. In addition, the study discusses novel therapies such as sclerotherapy and endovenous thermal ablation, as well as the effectiveness of existing diagnostic methods in detecting chronic venous illnesses. By investigating venous wall remodeling and inflammatory pathways, it gives a thorough knowledge of varicose vein formation. The study calls for future research that focuses on patient-centered methods, bioengineering advances, digital health applications, and genetic and molecular studies to improve the accuracy and effectiveness of vascular therapy. As a result, a multidisciplinary literature analysis was done, drawing on insights from vascular medicine, epidemiology, genetics, and pharmacology, to consolidate existing knowledge and identify possibilities to enhance varicose vein diagnosis, treatment, and patient care outcomes.

Figure 1

Schematic representation of blood circulation in lower limbs. Calf muscle pump is an essential component of venous circulation in lower limbs and the figure shows how venous valves prevent the backflow of blood in the lower limbs.

Figure 2

A summary of the lower limb venous system’s anatomy, physiology, and histology (The venous system in the lower limbs is a complex network responsible for returning deoxygenated blood to the heart. It is composed of superficial veins, deep veins, and perforating veins that connect the two systems. Varicose veins develop if these veins have dysfunctional valves.)

Figure 3

Historical perspective of varicose vein discovery and development of different treatment regimens over the time period.

Figure 4

Various risk factors and pathophysiology of varicose veins.

Figure 5

Schematic representation of immunophysiology of varicose veins.

Figure 6

Schematic representation for diagnostic approaches toward varicose veins.

Figure 7

CEAP {Clinical (C), Etiological (E), Anatomical (A), and Pathophysiological (P)} classification of varicose veins

Figure 8

Different available treatment modalities for varicose veins