Cost and effectiveness of laser with phlebectomies compared with foam sclerotherapy in superficial venous insufficiency. Early results of a randomised controlled trial

Eur J Vasc Endovasc Surg. 2012 May;43(5):594-600. doi: 10.1016/j.ejvs.2012.01.032. Epub 2012 Mar 3.

Abstract

Objectives: Quantify endovenous laser ablation (EVLA) with concurrent phlebectomies and ultrasound-guided foam sclerotherapy (UGFS) in cost and effectiveness at 3 weeks and 3 months.

Design: Single-centre, prospective, randomised controlled trial.

Patients: One hundred patients (100 legs), C(2-6), age 21-78, M:F 42:58, with primary varicose veins received either EVLA under local anaesthetic or UGFS.

Methods: Assessments included duplex, Aberdeen varicose vein questionnaire (AVVQ), venous clinical severity score (VCSS), venous filling index (VFI), visual analogue 7-day pain score and analgesia requirements. Additional treatments with UGFS were performed, if required. Micro-costing, using individually timed treatments, was based on consumables, staff pay and overheads.

Results: Changes in AVVQ, VCSS and VFI values (3 months) did not demonstrate any significant difference between groups. At 3 months, the above-knee GSV occlusion rate (without co-existing reflux) was not significantly different between the groups (74% vs 69%; EVLA vs UGFS; P = .596). Of the 9 haemodynamic failures in each group, 7 EVLA patients and 4 UGFS patients had co-existing cross-sectional above-knee GSV occlusion at some point. However, UGFS significantly outperformed EVLA in cost, treatment duration, pain, analgesia requirements and recovery.

Conclusions: UGFS is 3.15 times less expensive than EVLA (£230.24 vs £724.72) with comparable effectiveness but 56% (versus 6%) required additional foam (ISRCTN:03080206).

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Laser Therapy* / economics
  • Male
  • Middle Aged
  • Prospective Studies
  • Saphenous Vein / surgery*
  • Sclerotherapy* / economics
  • Treatment Outcome
  • Varicose Veins / economics
  • Varicose Veins / therapy*
  • Venous Insufficiency / economics
  • Venous Insufficiency / therapy*
  • Young Adult

Associated data

  • ISRCTN/ISRCTN03080206