Objective: to compare the clinical outcome of foam sclerotherapy of the great saphenous vein (GSV) combined with sapheno-femoral junction (SFJ) ligation to standard stripping surgery.
Methods: as a prospective randomized controlled trial, 60 consecutive patients with incompetence of the GSV resulting in varicose veins were prospectively randomized into 2 groups, treated by SFJ ligation and either foam sclerotherapy or standard stripping of the GSV. There were 26 male and 34 female with a median age of 49 years (ranging 37 to 66 years). Primary end points were patient recovery period, postoperative pain, quality of life and recurrence rate. Secondary end points were frequency of complications on the two arms of the trial.
Results: all treatments were completed as intended. The time taken to complete treatment was shorter in the foam sclerotherapy plus SFJ ligation group than the standard stripping (43 min vs. 65 min, P < 0.01). Less analgesic use postoperatively was recorded in the foam sclerotherapy group. Median time to return to normal activities was significantly reduced in the foam sclerotherapy group compared to the surgical group (3 d vs. 6 d, P < 0.01). After 3 months, median CEAP class dropped from four pre-operatively to one following treatment in both groups (P < 0.01). After 6 months, in the foam sclerotherapy group, 5 patients needed further sessions of foam sclerotherapy, resulting in a short-term closure rate of 80.0%. And the short-term obliteration rate was 89.5% in the conventional surgery group.
Conclusions: foam sclerotherapy combined with sapheno-femoral ligation involves a shorter treatment time, less postoperative discomfort and results in more rapid recovery compared to conventional GSV stripping.