Recent safety updates issued by the French National Agency for the Safety of Medicines and Health Products (ANSM) have once again drawn international attention to the potential cardiovascular risks associated with sclerotherapy for varicose veins, particularly foam sclerotherapy. Despite longstanding enhanced pharmacovigilance measures, serious adverse events including deep vein thrombosis, pulmonary embolism, and cardiac arrhythmias continue to be reported. This regulatory update highlights the growing global emphasis on patient selection, hemodynamic assessment, procedural standardization, and long-term safety outcomes in modern venous medicine.

This article highlights a critical paradigm shift in venous ulcer management, challenging the “gold standard” of Great Saphenous Vein (GSV) ablation. Recent findings by Bishara et al. (2024) demonstrate that in patients with Post-Thrombotic Syndrome (PTS) and deep venous obstruction, the GSV acts as a vital collateral bypass rather than a source of reflux. The study reveals that preserving the GSV in these specific cases leads to significantly higher healing probabilities and lower recurrence rates, whereas premature ablation can elevate regional venous pressure and stall recovery. A rigorous assessment of deep vein patency is now considered a mandatory prerequisite before any superficial intervention.