LymphedemaV1, Main, Exploration, bibRecord, 000B97

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 : 000B98

Randomized 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 Ck

Source :

The British Journal of Surgery [ 0007-1323 ] ; 2016.

RBID : PMC:5095806

Abstract

Background

Endovenous ablation techniques and ultrasound‐guided foam sclerotherapy (UGFS) 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 (EVLA) (with phlebectomies) and UGFS on quality of life and the occlusion rate of the great saphenous vein (GSV) 12 months after surgery.

Methods

Patients with symptomatic, uncomplicated varicose veins (CEAP class C2–C4) 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 (AVVSS).

Results

The study included 214 patients: 65 had surgery, 73 had EVLA and 76 had UGFS. At 1 year, the GSV was occluded or absent in 59 (97 per cent) of 61 patients after surgery, 71 (97 per cent) of 73 after EVLA and 37 (51 per cent) of 72 after UGFS (P < 0·001). The AVVSS 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 UGFS (mean 1 day) than after EVLA (8 days) and surgery (12 days).

Conclusion

In comparison with open surgery and EVLA, UGFS resulted in equivalent improvement in quality of life but significantly higher residual GSV reflux at 12‐month follow‐up.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095806

DOI: 10.1002/bjs.10260
PubMed: 27561823
PubMed Central: 5095806

Affiliations:

Le document en format XML

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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>
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<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>
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 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>
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, <styled-content style="fixed-case">UGFS</styled-content>
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Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound‐guided foam sclerotherapy for the treatment of great saphenous varicose veins

Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound‐guided foam sclerotherapy for the treatment of great saphenous varicose veins

Source :

Abstract

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