09 October 2014

Laser preferred treatment for varicose veins

    An article by HYMS Associate Dean (Research) Ian Chetter has been published in the New England Journal of Medicine.

    Ian was part of a collaborative group comparing three types of treatment for varicose veins. The group compared how quickly people recovered from the treatment and the likelihood of reoccurrence of the veins. Laser treatment was found to be the preferred method at the end of the study.

    Many people undergo treatment for varicose veins. Different types of treatment are available including surgery (removing the vein by stripping them out), laser (using the heat energy of a laser to close the vein) or injecting a foam (making the walls of the vein stick together so the bulging veins are not visible).

    Ian’s group compared the three treatments in terms of how well they worked from a participant and clinician perspective and their relative cost-effectiveness.

    Some 798 people with varicose veins requiring treatment were allocated by chance to one of these three treatments. Outcomes were assessed at six weeks and six months.

    The researchers found that all three treatments reduced the symptoms and signs associated with varicose veins and improved participants’ quality of life. However, compared with the other treatments, foam was less painful and allowed people to return to their normal activities more quickly but had fewer benefits in terms of patient-reported quality of life. It also had a higher rate of complications.

    Foam was also less likely to close a leaky vein, thus increasing the chance of needing more treatment in the future.

    Overall, the main findings of the study were that for patients who are suitable for all three treatment options, laser is the preferred one, based on consideration of both success at six months and estimated five-year costs and benefits.

    The group is following the study participants for five years as long-term results are important to determine the longer-term costs and consequences of the three treatments, ie recurrent varicose veins.

    http://www.nejm.org/doi/full/10.1056/NEJMoa1400781