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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.

Authors

Julie Brittenden

David Cooper

Maria Dimitrova

Graham Scotland

Seonaidh C. Cotton

Andrew Elders

Graeme MacLennan

Craig R. Ramsay

John Norrie

Jennifer M. Burr

Bruce Campbell

Paul Bachoo

Ian Chetter

Michael Gough

Jonothan Earnshaw

Tim Lees

Julian Scott

Sara A. Baker

Emma Tassie

Jill Francis

Marion K. Campbell



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

Journal Article Type Article
Publication Date Sep 5, 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
APA6 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
DOI https://doi.org/10.1056/NEJMoa1805186
Keywords General Medicine
Additional Information © 2019 Massachusetts Medical Society. Reprinted with permission.

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© 2019, Massachusetts Medical Society



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