Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial)

Abstract

Background: The 21st century has witnessed a rise in the use of endovenous thermal ablation. Being highly clinically and cost-effective and improving the quality of life of patients, they are now considered to be the ''gold-standard'' treatment for varicose veins. Postintervention management, especially in terms of postoperative compression; however, remains unclear. As a result, a randomized study was undertaken to investigate the effects of wearing compression stockings after varicose vein treatment. Method: Patients with saphenous vein reflux undergoing treatment with endothermal ablation (with or without concurrent phlebectomies) were randomized to receive either 7 days of compression stockings or no stockings. The primary outcome measure for this study was the pain score over the first 10 postoperative days. The pain scores, clinical score, time to return to normal activities, and ecchymosis were assessed. Patients were followed-up at 2 weeks and 6 months post-ablation. Results: In total, 206 patients were randomized, 49% of them to the compression group. The mean age was 49.7 (AE16) years and approximately 51% of the population was male. The median pain score in the compression group using a visual analog scale was significantly lower on days 2-5, compared to the no compression group. Those having concurrent phlebectomies and compression stockings also had significantly better pain scores on days 1-3, day 5, and day 7. Improvement in the median venous clinical severity score was noted at 6-month follow-up, but this was not significant. No difference in the generic-or disease-specific quality of life was observed and the time to return to activities was similar. There were no differences in the degree of ecchymosis between the 2 groups and both groups had similar occlusion rates. Conclusions: These results indicate that wearing compression stockings after endothermal ablation is advantageous in the first few days after treatment and is especially beneficial for those having concurrent phlebectomies.

Effect of Compression Stockings after Endovenous Laser Ablation of the Great Saphenous Vein with a 1470 nm Diode Laser Device and a 2ring Fiber

“…Long-term follow-up studies would be necessary to evaluate long-term occlusion rates. Most of our patients returned to normal daily activities the same or the next day, which is in accordance with other studies [11][12][13][14][15].…”

“…Additionally, in this study, a bare fiber was used in combination with an 810 nm diode laser. Bootun et al reported a significantly lower median pain score after the EVLA of saphenous veins in a compression group on days 2-5, compared to a no compression group in the COMETA trial [13]. Patients with additional phlebectomies and compression stockings had significantly lower pain scores on days 1-3, day 5, and day 7 compared to those who did not undergo compression [13].…”

“…Bootun et al reported a significantly lower median pain score after the EVLA of saphenous veins in a compression group on days 2-5, compared to a no compression group in the COMETA trial [13]. Patients with additional phlebectomies and compression stockings had significantly lower pain scores on days 1-3, day 5, and day 7 compared to those who did not undergo compression [13]. No significant differences concerning occlusion rates, quality of life, or bruising were found [13].…”

“…Compression treatment with bandages or compression stockings is used routinely after saphenous ablation to reduce pain, bruising and other side effects [5,6]. Recent studies demonstrated that the main effect of compression following GSV interventions is pain reduction within the first 7 days after treatment [7][8][9][10][11][12][13][14][15]. In most of these studies, additional phlebectomies were performed.…”

Varikozinės Venos: Diagnostika Ir Gydymas

“…vyrų), kuriems buvo taikyta ELT, viena grupė devėjo kompresines kojines, o kita nenaudojo jokių kompresinių priemonių. Rezultatai skelbia, jog kojinių dėvėjimas sumažino pooperacinį skausmą, kojų tinimą ir prisidėjo prie greitesnio fizinių kojos funkcijų atkūrimo [20].…”