Superficial vein
thrombosis of the legs requires comprehensive duplex ultrasonography of the superficial and deep leg veins. Only superficial vein
thrombosis less than 5 cm in length and more than 3 cm from the saphenofemoral or saphenopopliteal junction can be treated conservatively with compression, cooling, and relative immobilization. Superficial vein
thrombosis greater than 5 cm in length with more than 3 cm distance to the deep venous system is treated pharmacologically with
fondaparinux for 45 days (approved for 30-45 days). If the surface
thrombus reaches the saphenofemoral or saphenopopliteal junction at a distance of less than 3 cm,
therapy analogous to
deep vein thrombosis is required for 3 months. The most effective
therapy for
varicose veins is invasive removal. In this regard, endovenous thermal ablation has become particularly important in recent years, given that its effectiveness is of a similar order of magnitude to that of crossectomy and stripping surgery, but the complication rates are significantly lower. Invasive removal of
varicose veins not only improves patients' quality of life, but also significantly reduces the risk of
deep vein thrombosis. Recent epidemiological data demonstrate an increased risk of
cardiovascular disease in patients with chronic
venous insufficiency. There is preliminary evidence that this risk of
cardiovascular disease in
varicose vein patients can be lowered by
varicose vein therapy.