A randomized trial comparing treatments for varicose veins

2.50
Hdl Handle:
http://hdl.handle.net/11287/593809
Title:
A randomized trial comparing treatments for varicose veins
Authors:
Brittenden, J.; Cotton, S. C.; Elders, A.; Ramsay, C. R.; Norrie, J.; Burr, J.; Campbell, Bruce; Bachoo, P.; Chetter, I.; Gough, M.; Earnshaw, J.; Lees, T.; Scott, J.; Baker, S. A.; Francis, J.; Tassie, E.; Scotland, G.; Wileman, S.; Campbell, M. K.
Abstract:
BACKGROUND: Ultrasound-guided foam sclerotherapy and endovenous laser ablation are widely used alternatives to surgery for the treatment of varicose veins, but their comparative effectiveness and safety remain uncertain. METHODS: In a randomized trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of foam, laser, and surgical treatments. Primary outcomes at 6 months were disease-specific quality of life and generic quality of life, as measured on several scales. Secondary outcomes included complications and measures of clinical success. RESULTS: After adjustment for baseline scores and other covariates, the mean disease-specific quality of life was slightly worse after treatment with foam than after surgery (P=0.006) but was similar in the laser and surgery groups. There were no significant differences between the surgery group and the foam or the laser group in measures of generic quality of life. The frequency of procedural complications was similar in the foam group (6%) and the surgery group (7%) but was lower in the laser group (1%) than in the surgery group (P<0.001); the frequency of serious adverse events (approximately 3%) was similar among the groups. Measures of clinical success were similar among the groups, but successful ablation of the main trunks of the saphenous vein was less common in the foam group than in the surgery group (P<0.001). CONCLUSIONS: Quality-of-life measures were generally similar among the study groups, with the exception of a slightly worse disease-specific quality of life in the foam group than in the surgery group. All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment. (Funded by the Health Technology Assessment Programme of the National Institute for Health Research; Current Controlled Trials number, ISRCTN51995477.).
Citation:
N Engl J Med. 2014 Sep 25;371(13):1218-27.
Publisher:
NEJM
Journal:
The New England journal of medicine
Issue Date:
25-Sep-2014
URI:
http://hdl.handle.net/11287/593809
DOI:
10.1056/NEJMoa1400781
PubMed ID:
25251616
Additional Links:
http://www.nejm.org/doi/abs/10.1056/NEJMoa1400781?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Journal Article; Comparative Study; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Language:
eng
ISSN:
1533-4406
Appears in Collections:
Vascular Surgery; 2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBrittenden, J.en
dc.contributor.authorCotton, S. C.en
dc.contributor.authorElders, A.en
dc.contributor.authorRamsay, C. R.en
dc.contributor.authorNorrie, J.en
dc.contributor.authorBurr, J.en
dc.contributor.authorCampbell, Bruceen
dc.contributor.authorBachoo, P.en
dc.contributor.authorChetter, I.en
dc.contributor.authorGough, M.en
dc.contributor.authorEarnshaw, J.en
dc.contributor.authorLees, T.en
dc.contributor.authorScott, J.en
dc.contributor.authorBaker, S. A.en
dc.contributor.authorFrancis, J.en
dc.contributor.authorTassie, E.en
dc.contributor.authorScotland, G.en
dc.contributor.authorWileman, S.en
dc.contributor.authorCampbell, M. K.en
dc.date.accessioned2016-01-19T12:35:11Zen
dc.date.available2016-01-19T12:35:11Zen
dc.date.issued2014-09-25en
dc.identifier.citationN Engl J Med. 2014 Sep 25;371(13):1218-27.en
dc.identifier.issn1533-4406en
dc.identifier.pmid25251616en
dc.identifier.doi10.1056/NEJMoa1400781en
dc.identifier.urihttp://hdl.handle.net/11287/593809en
dc.description.abstractBACKGROUND: Ultrasound-guided foam sclerotherapy and endovenous laser ablation are widely used alternatives to surgery for the treatment of varicose veins, but their comparative effectiveness and safety remain uncertain. METHODS: In a randomized trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of foam, laser, and surgical treatments. Primary outcomes at 6 months were disease-specific quality of life and generic quality of life, as measured on several scales. Secondary outcomes included complications and measures of clinical success. RESULTS: After adjustment for baseline scores and other covariates, the mean disease-specific quality of life was slightly worse after treatment with foam than after surgery (P=0.006) but was similar in the laser and surgery groups. There were no significant differences between the surgery group and the foam or the laser group in measures of generic quality of life. The frequency of procedural complications was similar in the foam group (6%) and the surgery group (7%) but was lower in the laser group (1%) than in the surgery group (P<0.001); the frequency of serious adverse events (approximately 3%) was similar among the groups. Measures of clinical success were similar among the groups, but successful ablation of the main trunks of the saphenous vein was less common in the foam group than in the surgery group (P<0.001). CONCLUSIONS: Quality-of-life measures were generally similar among the study groups, with the exception of a slightly worse disease-specific quality of life in the foam group than in the surgery group. All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment. (Funded by the Health Technology Assessment Programme of the National Institute for Health Research; Current Controlled Trials number, ISRCTN51995477.).en
dc.language.isoengen
dc.publisherNEJMen
dc.relation.urlhttp://www.nejm.org/doi/abs/10.1056/NEJMoa1400781?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.goven
dc.titleA randomized trial comparing treatments for varicose veinsen
dc.typeJournal Articleen
dc.typeComparative Studyen
dc.typeMulticenter Studyen
dc.typeRandomized Controlled Trialen
dc.typeResearch Support, Non-U.S. Gov'ten
dc.identifier.journalThe New England journal of medicineen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en

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