Document Detail


Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins.
MedLine Citation:
PMID:  21725957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This randomized trial compared four treatments for varicose great saphenous veins (GSVs).
METHODS: Five hundred consecutive patients (580 legs) with GSV reflux were randomized to endovenous laser ablation (980 and 1470 nm, bare fibre), radiofrequency ablation, ultrasound-guided foam sclerotherapy or surgical stripping using tumescent local anaesthesia with light sedation. Miniphlebectomies were also performed. The patients were examined with duplex imaging before surgery, and after 3 days, 1 month and 1 year.
RESULTS: At 1 year, seven (5.8 per cent), six (4.8 per cent), 20 (16.3 per cent) and four (4.8 per cent) of the GSVs were patent and refluxing in the laser, radiofrequency, foam and stripping groups respectively (P < 0.001). One patient developed a pulmonary embolus after foam sclerotherapy and one a deep vein thrombosis after surgical stripping. No other major complications were recorded. The mean(s.d.) postintervention pain scores (scale 0-10) were 2.58(2.41), 1.21(1.72), 1.60(2.04) and 2.25(2.23) respectively (P < 0.001). The median (range) time to return to normal function was 2 (0-25), 1 (0-30), 1 (0-30) and 4 (0-30) days respectively (P < 0.001). The time off work, corrected for weekends, was 3.6 (0-46), 2.9 (0-14), 2.9 (0-33) and 4.3 (0-42) days respectively (P < 0.001). Disease-specific quality-of-life and Short Form 36 (SF-36(®)) scores had improved in all groups by 1-year follow-up. In the SF-36(®) domains bodily pain and physical functioning, the radiofrequency and foam groups performed better in the short term than the others.
CONCLUSION: All treatments were efficacious. The technical failure rate was highest after foam sclerotherapy, but both radiofrequency ablation and foam were associated with a faster recovery and less postoperative pain than endovenous laser ablation and stripping.
Authors:
L H Rasmussen; M Lawaetz; L Bjoern; B Vennits; A Blemings; B Eklof
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  98     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-04     Completed Date:  2011-09-07     Revised Date:  2012-02-01    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  1079-87     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Danish Vein Centres, Naestved, Denmark. lhr@varix.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Catheter Ablation / economics,  methods*
Costs and Cost Analysis
Endovascular Procedures / economics,  methods*
Female
Humans
Laser Therapy / economics,  methods*
Male
Middle Aged
Postoperative Complications / economics,  etiology
Saphenous Vein
Sclerotherapy / economics,  methods*
Severity of Illness Index
Treatment Outcome
Ultrasonography, Interventional
Varicose Veins / economics,  therapy*
Young Adult
Comments/Corrections
Comment In:
Br J Surg. 2011 Aug;98(8):1088   [PMID:  21725958 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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