Treatment of varicose veins, international consensus on which major complications to discuss with the patient: A Delphi study

Objective: To reach consensus on which complications of varicose vein treatments physicians consider major or minor, in order to standardize the informed consent procedure and improve shared decision-making. Methods: Using the e-Delphi method, expert physicians from 10 countries were asked to rate complications as “major” or “minor” on a 5-point Likert scale. Reference articles from a Cochrane review on varicose veins were used to compose the list of complications. Results: Participating experts reached consensus on 12 major complications: allergic reaction, cellulitis requiring intravenous antibiotics/intensive care, wound infection requiring debridement, hemorrhage requiring blood transfusion/surgical intervention, pulmonary embolism, skin necrosis requiring surgery, arteriovenous fistula requiring repair, deep venous thrombosis, lymphocele, thermal injury, transient ischemic attack/stroke, and permanent discoloration. Conclusion: An international consensus was reached about what physicians consider to be major complications of varicose vein treatments. This consensus may assist in standardizing the information physicians discuss with patients prior to varicose vein treatment.