Systematic Review and Meta-Analysis of Endovenous Radiofrequency Obliteration, Endovenous Laser Therapy, and Foam Sclerotherapy for Primary Varicosis

J Cardiovasc Surg (Torino). 2008 Apr;49(2):213-33.

Abstract

Aim: Radiofrequency obliteration (RFO), endovenous laser therapy (EVLT) and foam sclerotherapy (FS) are potential treatments for varicose veins. A systematic review was undertaken to assess their safety and effectiveness and to compare these endoluminal therapeutic options with conventional ligation and vein stripping.

Methods: An electronic health database search was performed on all studies published between 1970 and 2007 describing RFO, EVLT, and FS for treating varicose veins.

Results: Twenty-nine EVLT studies, 32 RFO studies and 22 FS trials were included. RFO was associated with the worst short and long-term safety and efficacy results compared to EVLT and FS regarding ''complete occlusion at the end of follow-up'', ''phlebitis'', ''deep vein thrombosis'', and ''paraesthesia''. EVLT had the best results concerning the long-term effectiveness parameters for ''occlusion at the end of follow-up'' and ''recanalization, recurrence or development of new veins'', compared to RFO and FS. Foam sclerotherapy of varicose veins is associated with a higher recurrence rate in patients with saphenofemoral incompetence compared to the rates after EVLT or RFO treatment.

Conclusion: EVLT, RFO, and FS seem to be safe and effective modalities with good short and mid-term

Results: Acquisition of comparative long-term and very long-term data on clinical efficacy (particularly with regard to the formation of recurrent varicose veins), safety, quality of life outcomes and costs is needed by large high-quality prospective randomized trials of endovenous techniques versus each other and versus surgery before considering endovenous techniques as the standard treatment.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Catheter Ablation* / adverse effects
  • Humans
  • Laser Therapy* / adverse effects
  • Sclerotherapy* / adverse effects
  • Treatment Outcome
  • Varicose Veins / surgery
  • Varicose Veins / therapy*