Comparative Study on Varicose Vein Treatments in the UK

Overview of the CLASS Study

Researchers in the UK undertook a comprehensive study to compare the outcomes of surgical and non-surgical treatments for varicose veins. This extensive, multi-center trial, named CLASS (Comparison of Laser, Surgery and Foam Sclerotherapy), was conducted across 11 health centers in the UK.

Non-Surgical Treatments Explored

The study focused on two non-surgical methods: Foam Sclerotherapy and Laser Ablation, comparing their long-term results with traditional surgery. Foam Sclerotherapy involves injecting a substance that causes the walls of the abnormal vein to swell and seal together. In contrast, Laser Ablation employs bursts of laser light to collapse the vein. Both techniques are minimally invasive and typically do not require an operating room.

Participant Selection and Study Design

Approximately 800 participants were selected based on specific criteria, including being over the age of 18, exhibiting symptoms of varicose veins, and being eligible for treatment. Participants were recruited from various health centers across the UK from 2008 to 2012. Advanced computer techniques were utilized to randomize the patients according to factors such as age, health center, sex, and specific symptoms, ensuring an unbiased comparison across the three treatment options. Both the assessors and participants were aware of their assigned groups and treatments throughout the study.

Follow-Up and Outcomes

After five years, nearly 600 of the initial participants completed and returned the questionnaires developed by the researchers. The results were promising, showing that participants reported increased satisfaction with their respective treatments (surgery, laser ablation, and foam sclerotherapy) and an improved disease-specific quality of life compared to five years prior. A significant portion of participants expressed a willingness to undergo the same treatment again and would recommend it to others.

Comparative Results of Treatments

While all three treatments yielded positive outcomes, notable differences emerged. The study indicated that laser ablation and surgery contributed to a higher quality of life index compared to foam sclerotherapy. This may be attributed to a lower incidence of varicose veins in the laser ablation and surgery groups after five years. Furthermore, researchers identified laser ablation as the most cost-effective treatment among the three.

Conclusions of the Study

The study concluded with a favorable perspective on treatment options for varicose veins. Although surgery remains the standard primary treatment, non-surgical methods such as laser ablation also proved to be effective, offering promising results in terms of quality of life and cost-effectiveness.

Author and Reference

Written by Sameena Ahmed
Reference: Julie Brittenden, M.D., David Cooper, Ph.D., Maria Dimitrova, M.Sc., Graham Scotland, Ph.D., et al. “Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins.” New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMoa1805186
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