A Decade of Varicose Vein Research, 2014–2024: What Two Bibliometric Studies Show About Where the Field Has Gone

How much has the field grown?

Two bibliometric studies published in early 2026 take stock of varicose vein research — one for the decade 2014–2024, one reaching back to 1987. A bibliometric study does not test a treatment; it analyses the literature itself: how many papers, from where, on what, cited by whom. Read carefully, that tells you where a field's attention has gone and where its evidence is thickest.

Here is what they found, and what it means for someone weighing treatment now.

Study 1 — Mao and colleagues, Medicine, 2026: the decade in numbers

Mao, Chen and Zhou searched the Web of Science Core Collection for English-language articles and reviews on varicose vein treatment published between 1 January 2014 and 31 December 2024, and separately reviewed 374 clinical trials registered in PubMed over the same period.

Volume. They identified 3,110 publications, with annual output growing substantially over the decade and peaking in 2021.

Who is doing the work. The leading contributors were the United States, China and the United Kingdom, with Imperial College London and the Mayo Clinic among the most prominent institutions. Phlebology and the Journal of Vascular Surgery were the dominant journals.

What it is about. Keyword analysis showed sustained interest in endovenous laser ablation and compression therapy, with pelvic congestion syndrome, cyanoacrylate closure and patient-reported outcomes emerging as growth topics.

The trials. Among the 374 clinical trials, randomised controlled trials dominated, focused on minimally invasive techniques — laser, radiofrequency, tissue adhesives — with a primary emphasis on efficacy, safety, recurrence and patient-centred outcomes, and a growing emphasis on long-term results and new devices. Trial registrations rose across the decade, with a notable peak around 2015.

Study 2 — Zhou and colleagues, Journal of Cardiothoracic Surgery, 2026: the longer view

A second group analysed the literature on minimally invasive treatment of great saphenous varicose veins from 1987 to 2024, again from Web of Science: 1,005 publications accumulating 24,820 citations. The United States led with 264 articles, followed by the United Kingdom (117) and China (72). Erasmus MC and Imperial College London were the leading institutions, and the Journal of Vascular Surgery and the European Journal of Vascular and Endovascular Surgery the leading venues. The central keywords were "reflux", "surgery" and "radiofrequency ablation", with rising interest in clinical practice guidelines.

Reading the two together

The centre of gravity has moved from surgery to endovenous treatment. Both studies show it: the keywords that dominate are endovenous laser, radiofrequency and adhesive closure, and the trials of the decade are overwhelmingly comparisons among minimally invasive methods rather than tests of open surgery. This is consistent with the guideline position — the Society for Vascular Surgery / American Venous Forum recommended thermal ablation over stripping for the incompetent great saphenous vein in 2011, and the 2022 update reaffirmed the endovenous-first approach.

The evidence base is deep, not just wide. Three thousand papers in a decade and over a thousand on minimally invasive treatment alone, with trials that now report at ten and fourteen years, mean that the main endovenous methods are among the better-evidenced procedures in vascular medicine. We have reviewed the long-term recurrence data and the trial comparisons between methods separately.

Two peaks, and an honest note about them. Publications peaked in 2021; trial registrations peaked around 2015. It is tempting to explain the 2021 publication peak by the pandemic — a shift toward outpatient, minimally invasive care, or simply more time to write — and that may be part of it. But the bibliometric data do not test causes, and a trial peak six years earlier suggests a more ordinary explanation: trials registered in the mid-2010s reporting their results, with the usual lag. The earlier Korean version of this article offered the pandemic explanation with more confidence than the data warrant; we have corrected that here.

The next questions are already visible. Patient-reported outcomes, long-term durability, non-thermal devices and pelvic venous disease are where the field's attention is turning. A patient reading the literature five years from now will find those questions much better answered than they are today.

What this means if you are choosing treatment

Three practical conclusions.

First, the minimally invasive methods are not experimental. They are the subject of the largest body of evidence in the field and the recommended first-line treatment in every major guideline.

Second, being the most-researched method is not the same as being the best method for you — the literature is thickest where the industry and academic interest has been, not necessarily where every patient's need lies. Older techniques such as phlebectomy have a smaller literature and a strong evidence base; we have made that argument elsewhere.

Third, the direction of the research — toward patient-reported outcomes and long-term results — is the direction in which patients' own questions lie. That is a good sign about the field.

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References

• Mao Y, Chen G, Zhou S. Global research trends and clinical trial progress in varicose vein treatment: A decade of advancements (2014-2024). Medicine (Baltimore). 2026;105(6):e47592. (PMID: 41650092)
• Zhou X, Zhou Z, Wang J, Li S, et al. Global trends and collaborative networks in minimally invasive treatments for great saphenous varicose veins: a bibliometric analysis. J Cardiothorac Surg. 2026;21(1). (PMID: 41725000)
• Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5 Suppl):2S-48S. (PMID: 21536172)
• Gloviczki P, Lawrence PF, Wasan SM, et al. The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part I. J Vasc Surg Venous Lymphat Disord. 2023;11(2):231-261.e6. (PMID: 36326210)