Clinical priority

The following approach to prioritising surgery for varicose veins has been proposed:

• top priority for varicose veins with complications
• medium priority for cases of trunk varicosities
• low priority for reticular varicosities and telangiectasiae

Referral from primary care with varicose veins:

• Refer people to a vascular service if they have any of the following:
  • with bleeding varicose veins - requires immediate referral to a vascular service
    
    
  • symptomatic* primary or symptomatic* recurrent varicose veins
    
    
  • lower-limb skin changes, such as pigmentation or eczema, thought to be caused by chronic venous insufficiency
    
    
  • superficial vein thrombosis (characterised by the appearance of hard, painful veins) and suspected venous incompetence
    
    
  • a venous leg ulcer (a break in the skin below the knee that has not healed within 2 weeks)
    
    
  • a healed venous leg ulcer

* veins found in association with troublesome lower limb symptoms (typically pain, aching, discomfort, swelling, heaviness and itching)

Reference:

• 1) NICE (July 2013). Varicose veins in the legs - The diagnosis and management of varicose veins