TY - JOUR
T1 - Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein
AU - Shadid, N.
AU - Ceulen, R.
AU - Nelemans, P.
AU - Dirksen, C.
AU - Veraart, J.
AU - Schurink, G. W.
AU - van Neer, P.
AU - Kley, J. Vd
AU - de Haan, E.
AU - Sommer, A.
PY - 2012/8
Y1 - 2012/8
N2 - Background: New minimally invasive treatment modalities, such as ultrasound-guided foam sclerotherapy (UGFS), are becoming more popular. In a multicentre randomized controlled non-inferiority trial, the effectiveness and costs of UGFS and surgery for treatment of the incompetent great saphenous vein (GSV) were compared. Methods: Patients with primary great saphenous varicose veins were assigned randomly to either UGFS or surgical stripping with high ligation. Recurrence, defined as reflux combined with venous symptoms, was determined on colour duplex scans at baseline, 3 months, 1 year and 2 years after initial treatment. Secondary outcomes were presence of recurrent reflux (irrespective of symptoms), reduction of symptoms, health-related quality of life (EQ-5D (TM)), adverse events and direct hospital costs. Results: Two hundred and thirty patients were treated by UGFS and 200 underwent GSV stripping. The 2-year probability of recurrence was similar in the UGFS and surgery groups: 11.3 per cent (24 of 213) and 9.0 per cent (16 of 177) respectively (P = 0.407). At 2 years, reflux irrespective of venous symptoms was significantly more frequent in the UGFS group (35.0 per cent) than in the surgery group (21.0 per cent) (P = 0.003). Mean(s.d.) hospital costs per patient over 2 years were 774(344) per patient for UGFS and 1824(141) for stripping. Conclusion: At 2-year follow-up, UGFS was not inferior to surgery when reflux associated with venous symptoms was the clinical outcome of interest. UGFS has the potential to be a cost-effective approach to a common health problem. Registration numbers: NCT01103258 () and NTR654 (). British Journal of Surgery Society Ltd. Published by
AB - Background: New minimally invasive treatment modalities, such as ultrasound-guided foam sclerotherapy (UGFS), are becoming more popular. In a multicentre randomized controlled non-inferiority trial, the effectiveness and costs of UGFS and surgery for treatment of the incompetent great saphenous vein (GSV) were compared. Methods: Patients with primary great saphenous varicose veins were assigned randomly to either UGFS or surgical stripping with high ligation. Recurrence, defined as reflux combined with venous symptoms, was determined on colour duplex scans at baseline, 3 months, 1 year and 2 years after initial treatment. Secondary outcomes were presence of recurrent reflux (irrespective of symptoms), reduction of symptoms, health-related quality of life (EQ-5D (TM)), adverse events and direct hospital costs. Results: Two hundred and thirty patients were treated by UGFS and 200 underwent GSV stripping. The 2-year probability of recurrence was similar in the UGFS and surgery groups: 11.3 per cent (24 of 213) and 9.0 per cent (16 of 177) respectively (P = 0.407). At 2 years, reflux irrespective of venous symptoms was significantly more frequent in the UGFS group (35.0 per cent) than in the surgery group (21.0 per cent) (P = 0.003). Mean(s.d.) hospital costs per patient over 2 years were 774(344) per patient for UGFS and 1824(141) for stripping. Conclusion: At 2-year follow-up, UGFS was not inferior to surgery when reflux associated with venous symptoms was the clinical outcome of interest. UGFS has the potential to be a cost-effective approach to a common health problem. Registration numbers: NCT01103258 () and NTR654 (). British Journal of Surgery Society Ltd. Published by
U2 - 10.1002/bjs.8781
DO - 10.1002/bjs.8781
M3 - Article
VL - 99
SP - 1062
EP - 1071
JO - British Journal of Surgery
JF - British Journal of Surgery
SN - 0007-1323
IS - 8
ER -