September 25, 2014
Varicose Vein Treatments: Surgery and Laser Therapy Better Than Foam Sclerotherapy
By Murad Alam, MD, MSCI
Surgical ligation and luminal laser ablation are both better than foam sclerotherapy for treating varicose veins, according to a New England Journal of Medicine study.
U.K. researchers randomized nearly 800 patients with primary varicose veins to foam, laser, or surgical treatment. At 6 weeks and at 6 months, disease-specific quality of life was moderately worse with foam sclerotherapy than with surgery; it did not differ between surgery and laser treatment. The rate of complications, most minor, was markedly lower with laser (1.0%) than with foam (6.2%) or surgery (7.1%). The rate of serious adverse events — 3% — did not differ across the groups.
These results confirm what has long been seen in comparative cohort studies — the relatively less invasive and less resource-intensive endovenous laser treatment, easily done in a procedure room, is as effective as surgical correction. This study had limitations: For example, the primary outcome measures were subjective and perhaps difficult to assess precisely, and there was some between-group crossover in treatment.
Dr. Alam is an associate editor with NEJM Journal Watch Dermatology, from which this story was adapted.
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