greetings from the Department of vascular surgery manipal hospital I'm Dr Aziz Pasha I'm going to brief you on varicose veins varicose veins are dileted torous elongated veins in the legs most of the people do not experience any pain but the signs and symptoms of this condition includes veins that are swollen lumpy and look tasted dark purple and bluish veins pain and aches in the legs heaviness of the Les legs especially after exercise or at night bleeding with mind injuries that is difficult to stop swok ankles and legs spider winds discoloration of the skin severe itching of the affected part cramps in the legs while standing for a long time and then ulceration coming to the risk factors it is more common in females between the age group of 40 to 50 it can be hereditary commonly seen dug in pregnancy and people who have standing occupation like teachers barbers policemen obesity then prior injury or surgery sedentary lifestyle coming to the complications the most common complication is hemorrhage from the ruptured varicose veins then we have pigmentation itching and dermatitis fenus ulcers lipo lipodermatosclerosis and then we deep wi thrombosis and recurrent thrombolitic coming to the evaluation all the patients should be examined both clinically as well as ultrasound examination coming to the treatment of Venus in insufficiency there is a conservative Management Open management endovenous therapy which includes thermal and non-thermal treatment of Venus insufficiency the first line always should be conservative management patient is advised to do exercise daily Elevate the legs often wear medical grade compression stockings the present therapy endovenous therapy which we regularly do in this we have both thermal and non-thermal in thermal we have endovenous radio frequency ablation endovenous laser ablation endovenous steam ablation and the non-thermal are chemical mechanico chemical and the glue that is called as venos indications for Venus endovenous procedure failed conservative therapy signs and symptoms of Venus insufficiency reflex proven by duplex scan the advantages of endovenous therapy there's less operative pain less complication early return of work and better quality of life [Music]