Researchers from the University of Glasgow report that laser ablation and surgery appear to be better options than ultrasound-guided foam sclerotherapy in a study that spanned 5 years and involved 600 patients.
Varicose vein is a chronic condition and new veins often occur after treatment. The treatments for varicose veins shunt blood from the affected veins to others. When this happens, the veins fade away. All three treatments essentially close off the swollen, twisted vein. The problem with getting rid of varicose veins is that even when one vein is destroyed, other varicose veins can appear over time.
Lead researcher Professor Dr. Julie Brittenden commented in a phone interview with Thailand Medical News "Minimally invasive treatment for varicose veins which destroy the vein by heat using a laser is the most effective treatment.”
In laser ablation, the doctor uses a laser's heat to close off the affected vein. This procedure involves a small cut in the skin and compression of the leg after the procedure.
Surgery involves inserting a tube into the vein, which closes the vein. Recovery usually takes a couple of weeks.
In foam sclerotherapy, the surgeon injects a solution into the vein, which scars it, forcing the blood to find an alternate route. This procedure usually takes several sessions and can be done in a doctor's office.
The differences in quality of life seen in the study are likely related to fewer patients experiencing new varicose veins with laser treatment and surgery than with foam.
Laser ablation was comparable to surgery concerning the quality of life, and had the highest chance of being cost-effective of the three treatments.
For the study, Brittenden and her colleagues randomly assigned nearly 600 patients to laser ablation, foam sclerotherapy or surgery. Of the nearly 600 patients who completed a quality-of-life questionnaire five years after their procedure, laser ablation and surgery were preferred over foam sclerotherapy.
Reference: Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins
Julie Brittenden, M.D., David Cooper, Ph.D., Maria Dimitrova, M.Sc., Graham Scotland, Ph.D., Seonaidh C. Cotton, Ph.D., https://www.nejm.org/doi/full/10.1056/NEJMoa1805186