title: Compression therapy versus surgery in the treatment of patients with varicose veins: A RCT.
abstract: OBJECTIVE
  Superficial venous reflux and varicose veins are common. The aim of this randomized controlled trial was to assess effectiveness of compression therapy compared with surgery for superficial venous reflux.
  
  
  METHODS
  153 patients with CEAP class C2-C3 and superficial venous reflux were randomized to receive either conservative treatment (compression stockings) (n = 77) or surgery (n = 76). Clinical examination including duplex ultrasound (DUS) was performed at entry and 1 and 2 years after randomization (compression group) or surgery (surgery group). Venous Clinical Severity Score without compression stockings (VCSS-S), Venous Segmental Disease Score (VSDS), Venous Disability Score (VDS), and health-related quality of life (HRQoL) were assessed at entry and at the follow-ups. Data were analysed on an intention-to-treat basis and according to the actual treatment performed.
  
  
  RESULTS
  At 2 years, 70/76 patients in the surgery group and 11/77 patients in the compression group had been operated on. VCSS-S decreased from 4.6 to 3.5 in the compression group (p < .01) and from 4.8 to 0.6 in the surgery group (p < .001). VSDS decreased from 7.7 to 7.0 in the compression group and from 8.2 to 0.9 in the surgery group (p < .0001). HRQoL did not change in the compression group, but improved significantly in the surgery group.
  
  
  CONCLUSIONS
  The surgical elimination of non-complicated superficial venous reflux is an effective treatment when compared with providing compression stockings only.
authors.affiliation: Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Sell
authors.affiliation: Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Vikatmaa
authors.affiliation: Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Albäck
authors.affiliation: Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Lepäntalo
authors.affiliation: Institute for Health and Welfare, Centre for Health and Social Economics, Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Malmivaara
authors.affiliation: Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland; Department of Vascular Surgery, Assiut University Hospitals, Assiut, Egypt.
authors.forename: O
authors.initials: O
authors.lastname: Mahmoud
authors.affiliation: Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland. Electronic address: maarit.venermo@hus.fi.
authors.forename: M
authors.initials: M
authors.lastname: Venermo
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005387:Finland; D006801:Humans; D057194:Intention to Treat Analysis; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011788:Quality of Life; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D053828:Stockings, Compression; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D014656:Vascular Surgical Procedures
keywords: Compression therapy; Operative treatment; Superficial venous reflux; Varicose veins