Randomized Controlled Clinical Trial of Sclerotherapy Alone Versus Sclerotherapy Plus Saphenofemoral Junction Ligation in Great Saphenous Varicose Vein

Abstract

Varicose veins are a common presentation, and its treatment has been a challenge for surgeons. Many studies have evaluated the efficacy of foam sclerotherapy with a high failure rate. One of the postulated reasons is inadequate obliteration of saphenofemoral junction with foam sclerotherapy. To test this hypothesis we compared whether there is a decrease in reflux with saphenofemoral junction ligation, along with foam sclerotherapy. Forty-eight patients (50 legs) with primary varicosities of the Great saphenous vein system were randomized into two groups: saphenofemoral junction ligation with foam sclerotherapy (SFJL + FS) and foam sclerotherapy alone (FS), and followed up at 2 months. There was complete disappearance of varicose veins in great saphenous vein territory in 96% of patients in SFJL + FS group, and 88% of patients in FS group. Veins ≥ 8 mm in diameter were incompletely occluded with sclerotherapy. Patient satisfaction score was comparable in both the groups. The addition of saphenofemoral junction ligation to foam sclerotherapy offers no additional patient benefit, particularly with regard to disappearance of varicose veins, relief of symptoms, recurrence, and morbidity. However, in large diameter veins (≥ 8 mm), saphenofemoral junction ligation with foam sclerotherapy gives better results.