Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins

Brittenden, Julie; Cooper, David; Dimitrova, Maria; Scotland, Graham; Cotton, Seonaidh C.; Elders, Andrew; MacLennan, Graeme; Ramsay, Craig R.; Norrie, John; Burr, Jennifer M.; Campbell, Bruce; Bachoo, Paul; Chetter, Ian; Gough, Michael; Earnshaw, Jonothan; Lees, Tim; Scott, Julian; Baker, Sara A.; Tassie, Emma; Francis, Jill; Campbell, Marion K.

Abstract

Copyright © 2019 Massachusetts Medical Society. BACKGROUND Endovenous laser ablation and ultrasound-guided foam sclerotherapy are recommended alternatives to surgery for the treatment of primary varicose veins, but their long-term comparative effectiveness remains uncertain. METHODS In a randomized, controlled trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of laser ablation, foam sclerotherapy, and surgery. Primary outcomes at 5 years were disease-specific quality of life and generic quality of life, as well as cost-effectiveness based on models of expected costs and quality-adjusted life-years (QALYs) gained that used data on participants' treatment costs and scores on the EuroQol EQ-5D questionnaire. RESULTS Quality-of-life questionnaires were completed by 595 (75%) of the 798 trial participants. After adjustment for baseline scores and other covariates, scores on the Aberdeen Varicose Vein Questionnaire (on which scores range from 0 to 100, with lower scores indicating a better quality of life) were lower among patients who underwent laser ablation or surgery than among those who underwent foam sclerotherapy (effect size [adjusted differences between groups] for laser ablation vs. foam sclerotherapy, −2.86; 95% confidence interval [CI], −4.49 to −1.22; P

Citation

Brittenden, J., Cooper, D., Dimitrova, M., Scotland, G., Cotton, S. C., Elders, A., …Campbell, M. K. (2019). Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins. New England Journal of Medicine, 381(10), 912-922. https://doi.org/10.1056/NEJMoa1805186

• Journal Article Type: Article
• Acceptance Date: Aug 29, 2019
• Publication Date: Sep 5, 2019
• Deposit Date: Dec 2, 2019
• Publicly Available Date: Dec 2, 2019
• Journal: New England Journal of Medicine
• Electronic ISSN: 1533-4406
• Publisher: Massachusetts Medical Society
• Peer Reviewed: Peer Reviewed
• Volume: 381
• Issue: 10
• Pages: 912-922
• DOI: https://doi.org/10.1056/NEJMoa1805186
• Keywords: General Medicine
• Public URL: https://hull-repository.worktribe.com/output/2702049
• Additional Information: © 2019 Massachusetts Medical Society. Reprinted with permission.