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Angiology
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Foam-Sclerotherapy, Surgery, Sclerotherapy, and Combined Treatment for Varicose Veins: A 10-Year, Prospective, Randomized, Controlled, Trial (VEDICO Trial)

G. Belcaro

Chieti, University and San Valentino, Vascular Screening Project, Pescara, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital at Imperial College, London, UK

M.R. Cesarone

Chieti, University and San Valentino, Vascular Screening Project, Pescara, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital at Imperial College, London, UK

A. di Renzo

Chieti, University and San Valentino, Vascular Screening Project, Pescara, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital at Imperial College, London, UK

R. Brandolini

Chieti, University and San Valentino, Vascular Screening Project, Pescara, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital at Imperial College, London, UK

L. Coen

Chieti, University and San Valentino, Vascular Screening Project, Pescara, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital at Imperial College, London, UK

G. Acerbi

Chieti, University and San Valentino, Vascular Screening Project, Pescara, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital at Imperial College, London, UK

C. Marelli

Chieti, University and San Valentino, Vascular Screening Project, Pescara, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital at Imperial College, London, UK

B.M. Errichi

Chieti, University and San Valentino, Vascular Screening Project, Pescara, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital at Imperial College, London, UK

M. Malouf

(St Mary's Hospital at Imperial College London, UK and CING, Nicosia, Cyprus

K. Myers

(St Mary's Hospital at Imperial College London, UK and CING, Nicosia, Cyprus

D. Christopoulos

(St Mary's Hospital at Imperial College London, UK and CING, Nicosia, Cyprus

A. Nicolaides

(St Mary's Hospital at Imperial College London, UK and CING, Nicosia, Cyprus

G. Geroulakos

(Ealing Hospital, Vascular Unit, London, UK

S. Vasdekis

(Vascular Surgery, University of Athens, Greece

E. Simeone

Casoli, Ch

A. Ricci

Pescara

I. Ruffini

Ortona, Ch

S. Stuard

Ortona, Ch

E. Ippolito

(Vascular Surgery, University of Milan

P. Bavera

(Vascular Surgery, University of Milan

M. Georgiev

(Venous Center, Latina, Italy

M. Corsi

Rome, Italy

M. Scoccianti

Rome, Italy

U. Cornelli

Milan, Italy

N. Caizzi

(Foggia, Italy

M. Dugall

London, UK

D. Christopoulos

Thessaloniki, Greece

M. Veller

Vascular Surgery, University of the Witwatersrand, Johannesburg

R. Venniker

Durban, South Africa

M. Cazaubon

(Paris, France

M. Griffin

(St Mary's Hospital at Imperial College London, UK

The study compared, by a prospective, randomized method, 6 treatment options: A: Sclero therapy ; B: High-dose sclerotherapy; C: Multiple ligations; D: Stab avulsion; E: Foam-sclero therapy ; F: Surgery (ligation) followed by sclerotherapy. Results were analyzed 10 years after inclusion and initial treatment. Endpoints of the study were variations in ambulatory venous pressure (AVP), refilling time (RT), presence of duplex-reflux, and number of recurrent or new incompetent venous sites. The number of patients, limbs, and treated venous segments were comparable in the 6 treatment groups, also comparable for age and sex distribution. The occur rence of new varicose veins at 5 years varied from 34% for group F (surgery + sclero) and ligation (C) to 44% for the foam + sclero group (E) and 48% for group A (dose 1 sclero). At 10 years the occurrence of new veins varied from 37% in F to 56% in A. At inclusion AVP was comparable in the different groups. At 10 years the decrease in AVP and the increase in RT (indicating decrease in reflux), was generally comparable in the different groups. Also at 10 years the number of new points of major incompetence was comparable in all treatment groups. These results indicate that, when correctly performed, all treatments may be similarly effective. "Standard," low-dose sclerotherapy appears to be less effective than high-dose sclero and foam-sclerotherapy which may obtain, in selected subjects, results comparable to surgery.

Angiology, Vol. 54, No. 3, 307-315 (2003)
DOI: 10.1177/000331970305400306
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