Varicose veins: The Daily PANCE Blueprint
A patient presents with prominent, tortuous veins in the lower legs but denies pain or swelling. What is the first-line management?
A. Sclerotherapy
B. Endovenous laser ablation
C. Compression stockings & elevation
D. Vein stripping and ligation
E. Warfarin anticoagulation
Answer and topic summary
The answer is C. Compression stockings & elevation
For asymptomatic varicose veins, the first-line management is always conservative. This includes Graduated Compression Stockings and leg elevation. These measures help counteract hydrostatic pressure, improve venous return, and prevent progression to chronic venous insufficiency or stasis dermatitis. Invasive procedures are typically reserved for patients who fail conservative therapy, have significant symptoms (pain, heaviness, ulcers), or for cosmetic concerns.
Board Pearl: Venous Stasis Dermatitis often mimics cellulitis but is usually bilateral and chronic. Remember that stasis dermatitis is treated with compression stockings
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