Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins

Introduction and Objective: To compare open surgery, Endovenous thermal ablation(EVTA) and ultrasound(USG) guided foam sclerotherapy for primary superficial venous insufficiency(PVI) with respect to obliteration of superficial venous system at 3 months, clinical outcome and cost. Materials and Meth...

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Main Author: Sandeep Raj Pandey
Format: Article
Language:English
Published: Society of Surgeons of Nepal 2016-07-01
Series:Journal of Society of Surgeons of Nepal
Subjects:
Online Access:https://www.nepjol.info/index.php/JSSN/article/view/15330
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author Sandeep Raj Pandey
author_facet Sandeep Raj Pandey
author_sort Sandeep Raj Pandey
collection DOAJ
description Introduction and Objective: To compare open surgery, Endovenous thermal ablation(EVTA) and ultrasound(USG) guided foam sclerotherapy for primary superficial venous insufficiency(PVI) with respect to obliteration of superficial venous system at 3 months, clinical outcome and cost. Materials and Methods: Between January 2015 to January 2016, all patients with symptomatic PVI of lower limbs who were willing for definitive management were randomized to open surgery (n=20), EVTA (n=40) or ultrasound guided foam sclerotherapy (n=20). In foam sclerotherapy group, review USG was done at 1 week and if necessary re-injection was done. The patients in all the groups underwent review USG at 3 months. Obliteration of superficial venous system, clinical outcome and costs were registered. Results: 5 patients in foam sclerotherapy group required re-injection at 1 week. Superficial venous system was obliterated in all the patients of all the groups at 3 months. Improvement in clinical score was similar in all groups. The foam sclerotherapy group had less frequent analgesia intake, earlier return to normal activity and lower cost. Local complication rate was slightly higher in foam sclerotherapy group. Conclusion: Foam sclerotherapy is a cheaper alternative to open surgery & EVTA for PVI with respective to early measures of clinical outcome. USG guided sclerotherapy demonstrated to be a safe and effective procedure for the treatment of chronic venous insufficiency. The observed complications were minimal and most of the patients reported satisfaction with the treatment outcomes. If patient have no cost issue, endovenous thermal ablation of varicose veins is better than open surgery & foam sclera in context of minimally invasive, cosmetic, less pain, no incisions, early ambulation & same day discharge.
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spelling doaj.art-15643d13c35f4123a6dc65c8257bd0452022-12-21T21:11:16ZengSociety of Surgeons of NepalJournal of Society of Surgeons of Nepal1815-39842392-47722016-07-0118310.3126/jssn.v18i3.15330Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veinsSandeep Raj PandeyIntroduction and Objective: To compare open surgery, Endovenous thermal ablation(EVTA) and ultrasound(USG) guided foam sclerotherapy for primary superficial venous insufficiency(PVI) with respect to obliteration of superficial venous system at 3 months, clinical outcome and cost. Materials and Methods: Between January 2015 to January 2016, all patients with symptomatic PVI of lower limbs who were willing for definitive management were randomized to open surgery (n=20), EVTA (n=40) or ultrasound guided foam sclerotherapy (n=20). In foam sclerotherapy group, review USG was done at 1 week and if necessary re-injection was done. The patients in all the groups underwent review USG at 3 months. Obliteration of superficial venous system, clinical outcome and costs were registered. Results: 5 patients in foam sclerotherapy group required re-injection at 1 week. Superficial venous system was obliterated in all the patients of all the groups at 3 months. Improvement in clinical score was similar in all groups. The foam sclerotherapy group had less frequent analgesia intake, earlier return to normal activity and lower cost. Local complication rate was slightly higher in foam sclerotherapy group. Conclusion: Foam sclerotherapy is a cheaper alternative to open surgery & EVTA for PVI with respective to early measures of clinical outcome. USG guided sclerotherapy demonstrated to be a safe and effective procedure for the treatment of chronic venous insufficiency. The observed complications were minimal and most of the patients reported satisfaction with the treatment outcomes. If patient have no cost issue, endovenous thermal ablation of varicose veins is better than open surgery & foam sclera in context of minimally invasive, cosmetic, less pain, no incisions, early ambulation & same day discharge.https://www.nepjol.info/index.php/JSSN/article/view/15330EVTAPVIfoams cleroUSG
spellingShingle Sandeep Raj Pandey
Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins
Journal of Society of Surgeons of Nepal
EVTA
PVI
foams clero
USG
title Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins
title_full Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins
title_fullStr Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins
title_full_unstemmed Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins
title_short Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins
title_sort study to compare open surgery endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins
topic EVTA
PVI
foams clero
USG
url https://www.nepjol.info/index.php/JSSN/article/view/15330
work_keys_str_mv AT sandeeprajpandey studytocompareopensurgeryendovenousthermalablationandultrasoundguidedfoamsclerotherapyfortreatmentofvaricoseveins