Study spots small differences in varicose vein treatments

A new study suggests that three common treatments for varicose veins are similarly effective in easing symptoms - but that small quality-of-life differences may be felt months after symptoms appear.

Researchers led by Julie Brittenden, M.D., professor of vascular surgery at the University of Aberdeen in Scotland, conducted a clinical trial that compared the three treatments - surgery, ultrasound-guided foam sclerotherapy and endovenous laser ablation. The trial was conducted at 11 centers in the United Kingdom and involved 798 patients diagnosed with primary varicose veins.

The researchers found that all three therapies were similarly effective in relieving symptoms such as pain, swelling and pruritus. They found that laser therapy was least likely to cause minor complications such as bleeding or bruising during the procedure. Six months later, patients who had received sclerotherapy rated it slightly lower in terms of quality of life, versus those who had undergone surgery or laser therapy.

The research team also found that sclerotherapy was least likely to successfully ablate the main branches of the great saphenous vein (55 percent of patients, compared with more than 80 percent of patients treated with surgery or laser therapy).

“Quality-of-life measures were generally similar among the study groups, with the exception of a slightly worse disease-specific quality of life in the foam group than in the surgery group,” study authors wrote. “All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment.”

The study was published in the Sept. 25 issue of the New England Journal of Medicine.

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