Varicose Veins: A Comparison of Surgery and Injection/Compression Sclerotherapy

Beresford, Shirley A.A.; Chant, A.D.B.; Jones, Helen M.F.; Piachaud, David; Weddell, J. M.

doi:10.1016/s0140-6736(78)90694-3

Cited by 52 publications

(24 citation statements)

References 5 publications

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“…This is due to a lack of uniformity for diagnosis, definition of patient inclusion criteria and treatment “failure,” outcome measurement, etc. Such comparisons have been admirably attempted in the past by Lujan et al 14 and others 15–19 . More recently, Einarsson et al 20 found surgery was superior to sclerotherapy; however, this conclusion must not be extrapolated to encompass more modern UGS methods.…”

Section: Discussionmentioning

confidence: 99%

Clinical Determinants of Ultrasound-guided Sclerotherapy Outcome

Kanter

1998

Dermatologic Surgery

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Larger doses of STS are required to induce vasospasm in older patients, males, and those with larger veins. Regardless of gender and age, larger veins are more likely to recanalize, but are not necessarily associated with clinical recurrence. Although older patients and males tend to have larger veins, their recanalization rates are similar to younger patients and females when sufficiently higher STS doses are used to induce vasospasm. Ambulatory patients of all ages and either gender may be good candidates for UGS if vasospasm is used as the treatment endpoint. Contrary to prevailing opinion, large vein caliber is not an absolute contraindication for UGS.

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Section: Discussionmentioning

confidence: 99%

Clinical Determinants of Ultrasound-guided Sclerotherapy Outcome

Kanter

1998

Dermatologic Surgery

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“…Surgery carries a significantly high rate of thromboembolism, nerve injury, and wound infection, plus small risks of general anesthesia 10–24 . Surgery is no more effective than foam ultrasound‐guided sclerotherapy for primary truncal saphenous vein treatment and less so for recurrent varicose veins.…”

Section: Discussionmentioning

confidence: 99%

Microfoam Ultrasound-Guided Sclerotherapy Treatment for Varicose Veins in a Subgroup with Diameters at the Junction of 10 mm or Greater Compared with a Subgroup of Less Than 10 mm

Barrett¹,

Allen²,

Ockelford³

et al. 2004

Dermatol Surg

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Ultrasound-guided foam sclerotherapy is effective in treating all sizes of varicose veins with high patient satisfaction and improvement in quality of life. Duplex ultrasound findings demonstrated a small increase in failure to close the saphenofemoral or saphenopopliteal junction with increasing size of junction diameter, but this does not significantly alter the results with respect to clearance of visible varicosities and patient satisfaction with results.

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“…However, when the three studies with Յ2 years follow-up were excluded, the decreased risk of recurrence with surgery became statistically significant (RR, 0.45; 95% CI, 0.22-0.93; I 2 ϭ 93%). Moreover, when older studies (Ͻ1980) were excluded in sensitivity analysis, 26,31,33,41 the results remained statistically significant (RR, 0.38; 95% CI, 0.16-0.90; I 2 ϭ 94%). No significant associations were found with other outcomes such as the risk of PE in four studies (RR 0.30; 95% CI, 0.06-1.46; I 2 ϭ 0%) and the proportion of patients satisfied (86% vs 82%; P ϭ .71); however, the small number of events makes these estimates imprecise.…”

Section: Sclerotherapy Studiesmentioning

confidence: 91%

“…56 In addition, patients in these studies preferred sclerotherapy, 33 which gave better initial results 26 and was less likely to require additional treatment. 31 However, studies with longer follow-up periods suggested that the initial benefits of sclerotherapy declined over time. For instance, Hobbs et al 41 found that surgery seemed more effective than sclerotherapy after 6 years and when the condition involved the saphenous system and there was proximal incompetence.…”

Section: Sclerotherapy Studiesmentioning

confidence: 99%