Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound‐guided foam sclerotherapy for the treatment of great saphenous varicose veins
Identifieur interne : 000B97 ( Main/Exploration ); précédent : 000B96; suivant : 000B98Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound‐guided foam sclerotherapy for the treatment of great saphenous varicose veins
Auteurs : M. Venermo ; J. Saarinen ; E. Eskelinen ; S. V H Aho ; E. Saarinen ; M. Railo ; I. Uurto ; J. Salenius ; A. Alb CkSource :
- The British Journal of Surgery [ 0007-1323 ] ; 2016.
Abstract
Endovenous ablation techniques and ultrasound‐guided foam sclerotherapy (
Patients with symptomatic, uncomplicated varicose veins (
The study included 214 patients: 65 had surgery, 73 had
In comparison with open surgery and
Url:
DOI: 10.1002/bjs.10260
PubMed: 27561823
PubMed Central: 5095806
Affiliations:
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound‐guided foam sclerotherapy for the treatment of great saphenous varicose veins</title>
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<author><name sortKey="Alb Ck, A" sort="Alb Ck, A" uniqKey="Alb Ck A" first="A." last="Alb Ck">A. Alb Ck</name>
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<series><title level="j">The British Journal of Surgery</title>
<idno type="ISSN">0007-1323</idno>
<idno type="eISSN">1365-2168</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><sec id="bjs10260-sec-0001"><title>Background</title>
<p id="bjs10260-para-0001">Endovenous ablation techniques and ultrasound‐guided foam sclerotherapy (<styled-content style="fixed-case">UGFS</styled-content>
) have largely replaced open surgery for treatment of great saphenous varicose veins. This was a randomized trial to compare the effect of surgery, endovenous laser ablation (<styled-content style="fixed-case">EVLA</styled-content>
) (with phlebectomies) and <styled-content style="fixed-case">UGFS</styled-content>
on quality of life and the occlusion rate of the great saphenous vein (<styled-content style="fixed-case">GSV</styled-content>
) 12 months after surgery.</p>
</sec>
<sec id="bjs10260-sec-0002"><title>Methods</title>
<p id="bjs10260-para-0002">Patients with symptomatic, uncomplicated varicose veins (<styled-content style="fixed-case">CEAP</styled-content>
class <styled-content style="fixed-case">C2–C4</styled-content>
) were examined at baseline, 1 month and 1 year. Before discharge and at 1 week, patients reported a pain score on a visual analogue scale. Preoperative and 1‐year assessments included duplex ultrasound imaging and the Aberdeen Varicose Vein Severity Score (<styled-content style="fixed-case">AVVSS</styled-content>
).</p>
</sec>
<sec id="bjs10260-sec-0003"><title>Results</title>
<p id="bjs10260-para-0003">The study included 214 patients: 65 had surgery, 73 had <styled-content style="fixed-case">EVLA</styled-content>
and 76 had <styled-content style="fixed-case">UGFS</styled-content>
. At 1 year, the <styled-content style="fixed-case">GSV</styled-content>
was occluded or absent in 59 (97 per cent) of 61 patients after surgery, 71 (97 per cent) of 73 after <styled-content style="fixed-case">EVLA</styled-content>
and 37 (51 per cent) of 72 after <styled-content style="fixed-case">UGFS</styled-content>
(<styled-content style="italic-in-any-context">P</styled-content>
< 0·001). The <styled-content style="fixed-case">AVVSS</styled-content>
improved significantly in comparison with preoperative values in all groups, with no significant differences between them. Perioperative pain was significantly reduced and sick leave shorter after <styled-content style="fixed-case">UGFS</styled-content>
(mean 1 day) than after <styled-content style="fixed-case">EVLA</styled-content>
(8 days) and surgery (12 days).</p>
</sec>
<sec id="bjs10260-sec-0004"><title>Conclusion</title>
<p id="bjs10260-para-0004">In comparison with open surgery and <styled-content style="fixed-case">EVLA</styled-content>
, <styled-content style="fixed-case">UGFS</styled-content>
resulted in equivalent improvement in quality of life but significantly higher residual <styled-content style="fixed-case">GSV</styled-content>
reflux at 12‐month follow‐up.</p>
</sec>
</div>
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<name sortKey="Eskelinen, E" sort="Eskelinen, E" uniqKey="Eskelinen E" first="E." last="Eskelinen">E. Eskelinen</name>
<name sortKey="Railo, M" sort="Railo, M" uniqKey="Railo M" first="M." last="Railo">M. Railo</name>
<name sortKey="Saarinen, E" sort="Saarinen, E" uniqKey="Saarinen E" first="E." last="Saarinen">E. Saarinen</name>
<name sortKey="Saarinen, J" sort="Saarinen, J" uniqKey="Saarinen J" first="J." last="Saarinen">J. Saarinen</name>
<name sortKey="Salenius, J" sort="Salenius, J" uniqKey="Salenius J" first="J." last="Salenius">J. Salenius</name>
<name sortKey="Uurto, I" sort="Uurto, I" uniqKey="Uurto I" first="I." last="Uurto">I. Uurto</name>
<name sortKey="V H Aho, S" sort="V H Aho, S" uniqKey="V H Aho S" first="S." last="V H Aho">S. V H Aho</name>
<name sortKey="Venermo, M" sort="Venermo, M" uniqKey="Venermo M" first="M." last="Venermo">M. Venermo</name>
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