title: Comparison of endovenous ablation techniques, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Extended 5-year follow-up of a RCT.
abstract: BACKGROUND
  This study compares the outcome 5 years after treatment of varicose veins with endovenous radiofrequency ablation (RFA), endovenous laser ablation (EVLA), ultrasound guided foam sclerotherapy (UGFS) or high ligation and stripping (HL/S) by assessing technical efficacy, clinical recurrence and the rate of reoperations.
  
  
  METHODS
  Five hundred patients (580 legs) with Great Saphenous Vein (GSV) reflux and varicose veins were randomized to one of the 4 treatments. Follow-up included clinical and duplex ultrasound examinations.
  
  
  RESULTS
  During 5 years there was a difference in the rate of GSV recanalization, recurrence and reoperations across the groups, KM P<0.001, P<0.01, P<0.001 respectively. Thus 8 in the RFA group (Kaplan Meier [KM] estimate 5.8%), 8 in the EVLA group (KM estimate 6.8%), 37 (KM estimate 31.5%) in the UGFS group and 8 in the HL/S group (KM estimate 6.3%) of GSVs recanalized or had a failed stripping procedure. Nineteen (RFA) (KM estimate 18.7%), 42 (EVLA) (KM estimate 38.6%), 28 (UGFS) (KM estimate 31.7%) and 38 (HL/S) (KM estimate 34.6%) legs developed recurrent varicose veins. Within 5 years after treatment, 19 (RFA) (KM estimate 17%), 19 (EVLA) (KM estimate 18.7%), 43 (UGFS) (KM estimate 37.7%) and 25 (HL/S) (KM estimate 23.4%) legs were retreated.
  
  
  CONCLUSIONS
  More recanalization's of the GSV occurred after UGFS and no difference in the technical efficacy was found between the other modalities during 5-year follow-up. The higher frequency of clinical recurrence after EVLA and HL/S cannot be explained and requires confirmation in other studies.
authors.affiliation: The Danish Vein Centers and Surgical Center Roskilde, Naestved, Denmark - lawaetzm@gmail.com.
authors.forename: Martin
authors.initials: M
authors.lastname: Lawaetz
authors.affiliation: The Danish Vein Centers and Surgical Center Roskilde, Naestved, Denmark.
authors.forename: Julie
authors.initials: J
authors.lastname: Serup
authors.affiliation: The Danish Vein Centers and Surgical Center Roskilde, Naestved, Denmark.
authors.forename: Birgit
authors.initials: B
authors.lastname: Lawaetz
authors.affiliation: The Danish Vein Centers and Surgical Center Roskilde, Naestved, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Bjoern
authors.affiliation: The Danish Vein Centers and Surgical Center Roskilde, Naestved, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Blemings
authors.affiliation: The Danish Vein Centers and Surgical Center Roskilde, Naestved, Denmark.
authors.forename: Bo
authors.initials: B
authors.lastname: Eklof
authors.affiliation: The Danish Vein Centers and Surgical Center Roskilde, Naestved, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Rasmussen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects*; D003718:Denmark; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D012008:Recurrence; D012086:Reoperation; D012501:Saphenous Vein / Q000601:surgery*; D015911:Sclerotherapy / Q000009:adverse effects*; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000601:surgery*; D055815:Young Adult