An alternative treatment for varicose veins: ligation plus foam sclerotherapy

Abstract

Background: Varicose vein treatment has been directed toward less-invasive yet lasting techniques.

Objective: To compare the effectiveness of an alternative treatment (ligation plus foam sclerotherapy) with that of a classic stripping technique.

Materials and methods: The study included 216 and 156 patients who had undergone classic stripping and foam sclerotherapy, respectively, within the previous 5 years. Preoperative and postoperative CEAP class, symptoms, recurrence, and Doppler findings of the two groups were compared.

Results: There were no differences between treatments in terms of postoperative symptoms, Doppler findings, or CEAP class. The predictors of postoperative CEAP class were bilateral limb disease and prior deep vein thrombosis (DVT), whereas the predictors of symptom recurrence were bilateral limb disease, preoperative CEAP class, occupation, and familial or genetic predisposition. The predictors of postoperative perforator incompetence (PI) were occupation, aged 60 and older, preoperative CEAP class, and preoperative PI, whereas the only predictor of postoperative deep vein incompetence (DVI) was preoperative DVI. Five-year symptom-free survival rates were 51 ± 0.8% in the foam sclerotherapy group and 46 ± 0.9% in the stripping group.

Conclusion: The safety and efficacy of ligation plus foam sclerotherapy as an alternative technique allowing for same-day surgery to treat varicose veins are the same as those of classic stripping. The predictors of postoperative outcome depend on individual patient characteristics.