Surgical Procedures Best Sclerotherapy for Varicose Veins

Laser ablation and surgery for varicose veins similarly improve quality of life (QOL), whereas foam sclerotherapy has less of an effect, claims a new study.

Researchers at the University of Glasgow (United Kingdom), the University of Aberdeen (United Kingdom), and nine other centers across the United Kingdom conducted a randomized, controlled trial involving 798 participants with primary varicose veins in order to compare outcomes of laser ablation, foam sclerotherapy, and surgery. The primary outcomes were disease-specific and generic QOL at follow-up, as well as cost-effectiveness based on models of expected costs and quality-adjusted life-years (QALYs).


Five years after the start of the trial, 595 patients had completed primary outcome analysis, which included 162 patients in the laser ablation group, 219 in the foam sclerotherapy group, and 214 in the surgery group. The rates of complete success with respect to truncal-vein ablation were 64% with laser ablation, 33.3% with foam sclerotherapy, and 75.9% with surgery. Additionally, in a two-way comparison between foam sclerotherapy and surgery, 54.5% of model iterations favored surgery. The study was published on September 4, 2019, in the New England Journal of Medicine.

“The results indicated a better QOL in patients who underwent laser ablation or surgery than among those who underwent foam sclerotherapy,” concluded lead author Julie Brittenden, MD, of the University of Glasgow, and colleagues. “The lesser presence and extent of varicose veins at five years in the ablation and surgery groups likely explain the differences in quality of life observed in the study.”

Varicose veins (also known as venous reflux disease) are a common condition that affects both men (25%) and women (40%). They are caused by weak or damaged vein walls and valves, which become enlarged and twisted when the blood pressure increases due to obesity, pregnancy, constipation, a tumor or poor circulation. They can occur anywhere from the groin to the ankle.

Related Links:
University of Glasgow
University of Aberdeen