A 50-year-old woman presents with painful, visible veins on her legs. She states she has been standing for long hours at her job for many years. She has tried compression stockings with minimal relief. What are her options for management?
This patient appears to have symptomatic varicose veins. Since conservative management with compression stockings has not provided sufficient relief, she may consider procedural interventions. Sclerotherapy, in which a solution is injected into the veins causing them to scar and fade, could be an option. Endovenous thermal ablation, using either laser or radiofrequency energy to close off the problematic veins, is another option. Surgical treatments, such as ligation and stripping, may also be considered, especially for larger varicose veins. The choice of treatment would depend on the size and location of the varicose veins, as well as the patient's overall health status and preferences.