Minimally Invasive Treatments for Varicose Veins

Surgical Rounds®, January 2014,

A group of researchers has assessed the health and economic costs and benefits of minimally invasive procedures for the management of varicose veins.

Though varicose veins have traditionally been treated with surgical stripping and ligation, they also respond to liquid sclerotherapy (LS) and conservative management. Both procedures have been associated with adverse events, which has prompted a search for minimally invasive treatments that reduce complications, speed recovery, and improve function at a lower cost.

In a recent issue of Health Technology Assessment, a group of researchers assessed the health and economic costs and benefits of minimally invasive procedures for the management of varicose veins. The authors systematically reviewed evidence on the treatments’ clinical efficacy and cost effectiveness and then applied an independent economic model to the data.

Their conclusions indicated that all currently available minimally invasive techniques for varicose vein management are similar in terms of efficacy, and each is a reasonable alternative to surgical stripping under appropriate circumstances.

Though the cost of each procedure varied considerably, the group deemed foam sclerotherapy the most cost-effective alternative to surgical stripping. However, patients treated with that option tended to have more deep vein thromboses (DVT) following the procedure.

The authors noted that successful outcomes with minimally invasive techniques require training and experience, as well as new equipment.