[Will foam sclerotherapy and endovenous thermal ablation replace varicose vein stripping?]

Praxis (Bern 1994). 2012 Oct 3;101(20):1297-307. doi: 10.1024/1661-8157/a001073.
[Article in German]

Abstract

Minimally invasive treatments of varicosis are increasingly establishing. Short and intermediate-term outcomes of endovenous treatments are satisfying: success rates are comparable with conventional surgery, whereas recovery is faster and complication rates are lower. Success rates are highest for endovenous laser ablation (EVLA). However, endovenous radiofrequency ablation (RFA) has advanced. Its short term outcomes are now comparable to EVLA, but with less side-effects. Ultrasound guided foam sclerotherapy (UGFS) replaced other forms of liquid sclerotherapy. In principle, this treatment can be combined with every other treatment for varicosis, but it loses its position as a monotherapy, due to poorer intermediate-term outcomes compared with EVLA and RFA. More prospective randomized controlled trials are needed in order to state an evidence based hierarchy of treatments for varicosis. With the minimally invasive treatments it is possible to treat patients on an outpatient basis. It will have to be assessed whether this will lead to higher cost-effectiveness.

Publication types

  • Comparative Study
  • English Abstract
  • Review

MeSH terms

  • Catheter Ablation / methods
  • Dosage Forms
  • Humans
  • Laser Therapy / methods
  • Leg / blood supply
  • Minimally Invasive Surgical Procedures / methods*
  • Sclerosing Solutions / administration & dosage
  • Sclerotherapy / methods
  • Secondary Prevention
  • Treatment Outcome
  • Ultrasonography, Interventional / methods
  • Varicose Veins / surgery*
  • Veins / surgery

Substances

  • Dosage Forms
  • Sclerosing Solutions