No Verdict on Varicose Vein Therapy
Brittenden J, Cotton SC, Elders A, et al
N Engl J Med. 2014;371:1218-1227
Do the results of varicose vein treatment depend on the treatment method? Brittenden and colleagues performed a multicenter randomized controlled trial involving 798 patients treated in the United Kingdom with three different methods: laser (n = 210), injected foam (n = 286), or surgery (n = 289). (Thirteen patients were excluded after randomization.) Several outcomes were measured, including quality of life, which was similar in all three groups. In regard to successful ablation of main trunks of the saphenous vein, both surgery and laser were superior to foam at 6 months. (P < .01). Laser therapy was associated with somewhat fewer complications.
Patients have several options for treatment of varicose veins, which is a common affliction of the lower extremities. This report gives results for three of the most common methods for this condition, but it excluded radiofrequency ablation. The results for the three methods included in the study were reasonably similar except for lower rates of occlusion of the main saphenous trunk using foam, and lower overall complication rates with laser therapy. The follow-up period was only 6 months, so the final results may change with a longer period of observation.
Abstract
A Randomized Trial Comparing Treatments for Varicose Veins
Brittenden J, Cotton SC, Elders A, et al
N Engl J Med. 2014;371:1218-1227
Study Summary
Do the results of varicose vein treatment depend on the treatment method? Brittenden and colleagues performed a multicenter randomized controlled trial involving 798 patients treated in the United Kingdom with three different methods: laser (n = 210), injected foam (n = 286), or surgery (n = 289). (Thirteen patients were excluded after randomization.) Several outcomes were measured, including quality of life, which was similar in all three groups. In regard to successful ablation of main trunks of the saphenous vein, both surgery and laser were superior to foam at 6 months. (P < .01). Laser therapy was associated with somewhat fewer complications.
Viewpoint
Patients have several options for treatment of varicose veins, which is a common affliction of the lower extremities. This report gives results for three of the most common methods for this condition, but it excluded radiofrequency ablation. The results for the three methods included in the study were reasonably similar except for lower rates of occlusion of the main saphenous trunk using foam, and lower overall complication rates with laser therapy. The follow-up period was only 6 months, so the final results may change with a longer period of observation.
Abstract
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