Objective To observe the effects of diosmin and rivaroxaban respectively combined with endovenous microwave ablation closure (EMA) and polidocanol in the treatment of lower extremity varicose veins (VVLE), as well as their impacts on coagulation function, Visual Analogue Scale (VAS) scores, and venous clinical severity score (VCSS).

Methods A total of 111 patients with VVLE were selected as the research subjects and divided into Group A, Group B, and Group C using the random number table method, with 37 patients in each group. Group A was treated with EMA and polidocanol, Group B was treated with diosmin combined with EMA and polidocanol, and Group C was treated with rivaroxaban combined with EMA and polidocanol. The VAS scores, VCSS, coagulation function indicators prothrombin time (PT), D-dimer (D-D), fibrinogen (FIB), activated partial thromboplastin time (APTT), and the incidence of complications were compared among the three groups.

Results After treatment, the VAS scores and VCSS in all three groups were lower than those before treatment. Moreover, the scores in Group C and Group B were lower than those in Group A, and the scores in Group B were lower than those in Group C, with statistically significant differences (P < 0.05). After treatment, the PT, APTT, and FIB in all three groups were longer or higher than those before treatment, but the differences were not statistically significant (P>0.05). After treatment, the D-D levels in Group A and Group B were higher than those before treatment, while the D-D level in Group C was lower than that before treatment. Additionally, the D-D level in Group C was lower than those in Group A and Group B, with a statistically significant difference (P < 0.05). The incidence of various postoperative complications and the total complication rate in Group B and Group C were lower than those in Group A, and the rates in Group B were lower than those in Group C, with statistically significant differences (P < 0.05).

Conclusion The diosmin combined with EMA and polidocanol regimen has more advantages in reducing the incidence of postoperative complications and improving VAS scores and VCSS. The rivaroxaban combined with EMA and polidocanol regimen shows better performance in reducing the risk of postoperative lower extremity venous thrombosis. Both combined regimens are safe and effective in the treatment of VVLE, and do not affect coagulation function or increase the risk of bleeding.