title: Consensus statement on the symptom-based treatment of chronic venous diseases.
abstract: BACKGROUND
  Chronic venous diseases are very common. Early symptoms such as a sensation of swelling and heaviness may occur without objectifiable findings, but are nevertheless perceived as bothersome. Progressive disease - marked by varicose veins and symptoms of chronic venous insufficiency - is associated with considerable impairment in quality of life.
  
  
  METHODS
  The present consensus recommendations are based on publications in Pubmed-listed journals as well as relevant international therapeutic guidelines on chronic venous diseases. Only conclusive randomized controlled trials (RCTs) and review articles/meta-analyses were included.
  
  
  RESULTS
  Symptom-based treatment of chronic venous diseases is based on three therapeutic pillars with proven efficacy: invasive therapy, compression therapy, and oral pharmacological treatment. According to current therapeutic guidelines, invasive procedures aimed at restoring unimpaired venous blood flow as well as improving or eliminating pathological changes should be the first-line approach. If an invasive approach is infeasible or undesirable, or if symptoms persist following a therapeutic intervention, optimal use of symptom-based treatment options is recommended. Compression and pharmacological therapy may each be used as sole treatment or in combination. To guarantee maximum therapeutic success, individual treatment decisions should be made on a case-by-case basis.
  
  
  CONCLUSIONS
  Chronic venous diseases should be treated on the basis of individual pathophysiological disturbances. Symptom-based treatment of chronic venous disorders encompasses invasive therapy, compression therapy, and oral pharmacological therapy. Considerations in choosing the appropriate treatment option should include both objective signs as well as subjective symptoms.
authors.affiliation: Department of Dermatology and Allergology, and Center for Venous Disorders of the Departments of Dermatology and Vascular Surgery, Ruhr University Bochum, Bochum, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Stücker
authors.affiliation: Department of Vascular Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Eike Sebastian
authors.initials: ES
authors.lastname: Debus
authors.affiliation: Department of Vascular Surgery and Phlebology at the Contilia Cardiovascular Center, Elisabeth Hospital Essen, and Division of Vascular Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hoffmann
authors.affiliation: Department of Dermatology, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Jünger
authors.affiliation: Division of Angiology, Department of Vascular Medicine, HELIOS Medical Center Krefeld, Krefeld, Germany.
authors.forename: Knut
authors.initials: K
authors.lastname: Kröger
authors.affiliation: Department of Vascular Surgery, and Center for Venous Disorders of the Departments of Dermatology and Vascular Surgery, Ruhr University Bochum, Bochum, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Mumme
authors.affiliation: Department of Dermatology, Inselspital Bern, Bern, Switzerland.
authors.forename: Albert-Adrien
authors.initials: AA
authors.lastname: Ramelet
authors.affiliation: Department of Dermatology and Allergology, Bonn, Germany, University of Bonn, Bonn, Germany.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Rabe
mesh_terms: D002908:Chronic Disease; D032921:Consensus; D006801:Humans; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D014648:Varicose Veins; D014689:Venous Insufficiency / Q000628:therapy*