Five-year outcomes of a randomized trial of treatments for varicose veins

Julie Brittenden, Seonaidh Cotton, David Cooper, Maria Dimitrova, Graham Scotland, Andrew Elders, Graeme MacLennan, Craig Ramsay, J Norrie, Jennifer Burr, Bruce Campbell, Paul Bachoo, Ian Chetter, Michael Gough, Jonothan Earnshaw, Tim Lees, Julian Scott, Sara Baker, Emma Tassie, Jill FrancisMarion Campbell

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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
Original languageEnglish
Pages (from-to)912-922
Number of pages11
JournalNew England Journal of Medicine
Issue number10
Publication statusPublished - 5 Sep 2019


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Brittenden, J., Cotton, S., Cooper, D., Dimitrova, M., Scotland, G., Elders, A., MacLennan, G., Ramsay, C., Norrie, J., Burr, J., Campbell, B., Bachoo, P., Chetter, I., Gough, M., Earnshaw, J., Lees, T., Scott, J., Baker, S., Tassie, E., ... Campbell, M. (2019). Five-year outcomes of a randomized trial of treatments for varicose veins. New England Journal of Medicine, 381(10), 912-922.