Duplex Guided Foam Sclerotherapy Versus Surgery in Management of Primary Varicose Veins

Abstract

Background: Varicose veins is a major problem among adult population. It has a major effect on life quality as well as healthcare system resources, we aim in this study to compare ultrasound guided foam sclerotherapy (UGFS) with surgery in management of primary varicose veins patients and to measure patients’ satisfaction with either modalities. Methods: 100 lower limbs of 100 patients with great saphenous vein (GSV) incompetence were prospectively randomized to undergo either surgical treatment or foam sclerotherapy. Clinical, etiological, anatomical and pathophysiological (CEAP) Classification and the Venous Clinical Severity Score (VCSS) were completed and investigated with a follow-up period of 1 year. Results: Total occlusion of great saphenous vein (GSV) was 88% in foam group as well as in the surgery group, recurrence rate in the foam group was 6% as well as in surgery group. Patient satisfaction at 1 year was 94% in foam group while in surgery group it was 90%. There were no statistical significant differences in follow up regarding VCSS, recurrence, patient satisfaction between both groups at 1 month, 6 months and 1 year (p value>0.001). Conclusion: Surgical treatment and UGFS achieved elevated rates of total occlusion of GSV incompetence with no significant difference. Both treatments led to significant improvements in VCSS, demonstrating improvements in clinical outcomes. UGFS is a valid noninvasive modality in management of great saphenous vein incompetence and is comparable to surgery.