Results of surgical treatment compared with ultrasound-guided foam sclerotherapy in patients with varicose veins: a prospective randomised study.
OBJECTIVE
This study aims to compare venous clinical severity scores in patients with healed venous ulcers due to varicose veins of the lower limbs (the clinical, etiologic, anatomic, and pathophysiologic data (CEAP) classification: C(5) EpAsPr) treated by saphenous stripping and phlebectomy or by ultrasound-guided foam sclerotherapy.


METHODS
Sixty patients were included: 29 underwent saphenous stripping and phlebectomy for varices in saphenous tributaries and 27 were treated by ultrasound-guided foam sclerotherapy; four cases were lost to follow-up. The main outcome measure was venous clinical severity scores (pain, oedema, inflammation, hyperpigmentation and lipodermatosclerosis). An ultrasound examination was carried out prior to treatment and 30, 60 and 180 days after the procedure to assess the relative efficacy of the methods in obliterating the saphenous trunk.


RESULTS
The mean venous clinical severity scores measured before and after 180 days were as follows: Surgery group - pain: before 1.97 standard deviation (SD) 0.19, 180 days 0.72 SD 0.53; oedema: before 1.66 SD 0.48, 180 days 0.55 SD 0.63; inflammation: before 1.55 SD 0.63, 180 days 0.72 SD 0.45. Foam sclerotherapy group - pain: before 1.81 SD 0.40, 180 days 0.56 SD 0.51; oedema: before 1.70 SD 0.47, 180 days 0.48 SD 0.64; inflammation: before 1.67 SD 0.68, after 0.89 SD 0.32. All scores showed statistically significant reductions in both patient groups. The saphenous vein had been obliterated, 180 days after treatment, in 78% of the surgery group, compared with 90% in the foam sclerotherapy group.


CONCLUSIONS
Ultrasound-guided foam sclerotherapy is a safe and effective option for patients with chronic venous disorders.
Figueiredo
M
M
Universidade Federal de São Paulo, São Paulo, SP, Brazil. drmarcondes@gmail.com
Araújo
S
S
Barros
N
N
Miranda
F
F
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004487:Edema / Q000209:etiology / Q000628:therapy; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D015911:Sclerotherapy; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional; D014648:Varicose Veins / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D014656:Vascular Surgical Procedures; D014945:Wound Healing