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Wright D, Gobin JP, Bradbury AW, Coleridge-Smith P, Spoelstra H, Berridge D, Wittens CHA, Sommer A, Nelzen O, Chanter D. Varisolve® polidocanol microfoam compared with surgery or sclerotherapy in the management of varicose veins in the presence of trunk vein incompetence: European randomized controlled trial. Phlebology 2016. [DOI: 10.1258/026835506779115807] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: To compare the safety and efficacy of Varisolve® 1% polidocanol microfoam sclerosant with alternative treatments for patients with varicose veins and trunk vein incompetence. Methods: An open-label, multicentre, prospective trial of 710 patients randomized to receive either Varisolve® or alternative treatment (surgery or sclerotherapy). The endpoint was ultrasound-determined occlusion of trunk vein(s) and elimination of reflux, analysed against a non-inferiority hypothesis. Results: Overall, non-inferiority was demonstrated with 83.4% efficacy for Varisolve® compared with 88.1% for alternative treatment at three months, and the corresponding magnitudes were 78.9 and 80.4% at 12 months. Surgery was superior to Varisolve®, but the success rate of 68.2% for Varisolve® (surgery 87.2%) was poor compared with 93.8% success for Varisolve® achieved in those randomized to Varisolve® or sclerotherapy. Varisolve® was superior to sclerotherapy at 12 months ( P = 0.001). Deep vein thrombosis occurred in 11/437 (2.5%) after Varisolve®, in 1/125 (0.8%) after sclerotherapy and in none after surgery. No pulmonary emboli were detected. Conclusion: Overall, Varisolve® was non-inferior to alternative treatment. Surgery was more efficacious, but Varisolve® caused less pain and patients returned to normal more quickly. The Varisolve® technique is a useful additional treatment for varicose veins and trunk vein incompetence.
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Affiliation(s)
| | - J P Gobin
- Cabinet De Medecine Vasculaire, Lyon, France
| | - A W Bradbury
- University of Birmingham, and Heart of England NHS Foundation Trust, Birmingham, UK
| | | | - H Spoelstra
- Therapeutisch Vascular Centrum, Gavere, Belgium
| | - D Berridge
- Leeds Vascular Institute, The General Infirmary at Leeds, Leeds, UK
| | - C H A Wittens
- Department of Vascular Surgery, Sint Franciscus Gasthuis Kleiweg, Rotterdam, The Netherlands
| | - A Sommer
- Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands
| | - O Nelzen
- Vascular Surgery Unit, Department of Surgery, Skaraborg Hospital, Skovde, Sweden
| | - D Chanter
- Statisfaction Statistical Consultancy Ltd, Bexhill on Sea, UK
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Mosti G, De Maeseneer M, Cavezzi A, Parsi K, Morrison N, Nelzen O, Rabe E, Partsch H, Caggiati A, Simka M, Obermayer A, Malouf M, Flour M, Maleti O, Perrin M, Reina L, Kalodiki E, Mannello F, Rerkasem K, Cornu-Thenard A, Chi YW, Soloviy M, Bottini O, Mendyk N, Tessari L, Varghese R, Etcheverry R, Pannier F, Lugli M, Carvallo Lantz AJ, Zamboni P, Zuolo M, Godoy MF, Godoy JM, Link DP, Junger M, Scuderi A. Society for Vascular Surgery and American Venous Forum Guidelines on the management of venous leg ulcers: the point of view of the International Union of Phlebology. INT ANGIOL 2015; 34:202-218. [PMID: 25896614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- G Mosti
- Department of Angiology, Barbantini Clinic, Lucca, Italy
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Nicolaides A, Kakkos S, Eklof B, Perrin M, Nelzen O, Neglen P, Partsch H, Rybak Z. Management of chronic venous disorders of the lower limbs - guidelines according to scientific evidence. INT ANGIOL 2014; 33:87-208. [PMID: 24780922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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