title: Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy for the treatment of great saphenous varicose veins.
abstract: BACKGROUND
  Endovenous ablation techniques and ultrasound-guided foam sclerotherapy (UGFS) have largely replaced open surgery for treatment of great saphenous varicose veins. This was a randomized trial to compare the effect of surgery, endovenous laser ablation (EVLA) (with phlebectomies) and UGFS on quality of life and the occlusion rate of the great saphenous vein (GSV) 12 months after surgery.
  
  
  METHODS
  Patients with symptomatic, uncomplicated varicose veins (CEAP class C2-C4) were examined at baseline, 1 month and 1 year. Before discharge and at 1 week, patients reported a pain score on a visual analogue scale. Preoperative and 1-year assessments included duplex ultrasound imaging and the Aberdeen Varicose Vein Severity Score (AVVSS).
  
  
  RESULTS
  The study included 214 patients: 65 had surgery, 73 had EVLA and 76 had UGFS. At 1 year, the GSV was occluded or absent in 59 (97 per cent) of 61 patients after surgery, 71 (97 per cent) of 73 after EVLA and 37 (51 per cent) of 72 after UGFS (P < 0·001). The AVVSS improved significantly in comparison with preoperative values in all groups, with no significant differences between them. Perioperative pain was significantly reduced and sick leave shorter after UGFS (mean 1 day) than after EVLA (8 days) and surgery (12 days).
  
  
  CONCLUSIONS
  In comparison with open surgery and EVLA, UGFS resulted in equivalent improvement in quality of life but significantly higher residual GSV reflux at 12-month follow-up.
authors: Department of Vascular Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland. maarit.venermo@hus.fi.
authors: M
authors: M
authors: Venermo
authors: Department of Surgery, Tampere University Hospital, Tampere, Finland.
authors: J
authors: J
authors: Saarinen
authors: Department of Vascular Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
authors: E
authors: E
authors: Eskelinen
authors: Department of Vascular Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
authors: S
authors: S
authors: Vähäaho
authors: Department of Vascular Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
authors: E
authors: E
authors: Saarinen
authors: Department of Vascular Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
authors: M
authors: M
authors: Railo
authors: Department of Surgery, Tampere University Hospital, Tampere, Finland.
authors: I
authors: I
authors: Uurto
authors: Department of Surgery, Tampere University Hospital, Tampere, Finland.
authors: J
authors: J
authors: Salenius
authors: Department of Vascular Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
authors: A
authors: A
authors: Albäck
mesh_terms: D000328:Adult; D000368:Aged; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012501:Saphenous Vein; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D018582:Sick Leave / Q000706:statistics & numerical data; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional / Q000379:methods; D014648:Varicose Veins / Q000628:therapy*; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions