• Lissa Severo Sakugawa, Felipe Soares Oliveira Portela, Andressa Cristina Sposato Louzada, Maria Fernanda Cassino Portugal, Marcelo Passos Teivelis, Cynthia de Almeida Mendes, Lucas Lembrança Pinheiro, Marcelo Fiorelli Alexandrino da Silva, Alexandre Fioranelli, and Nelson Wolosker.
• Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
• Clinics (Sao Paulo). 2024 Jan 1; 79: 100346100346.

Background And ObjectiveLower limb varicose veins are a prevalent disease associated with several available treatment options, including conventional surgery and polidocanol foam sclerotherapy. However, few studies have analyzed therapeutic modality outcomes based on Patient-Reported Outcome Measures (PROMs). This large sample-size study was designed to evaluate the outcomes of polidocanol foam sclerotherapy compared to conventional surgery based on an analysis of PROMs.MethodsThis was a prospective, observational, and qualitative study of 205 patients who underwent varicose vein treatment with either polidocanol foam sclerotherapy (57 patients, 90 legs) or conventional surgery (148 patients, 236 legs). Patients were preoperatively assessed and re-evaluated 30 days after the procedure using the Venous Disease Severity Score (VCSS) and specific venous disease quality-of-life questionnaires (VEINES-QoL/Sym).ResultsBoth treatments significantly improved VCSS and VEINES results 30 days after the procedure (p < 0.05). However, surgery promoted greater improvements in VCSS (on average 4.02-points improvement, p < 0.001), VEINES-QoL (average 8-points improvement, p < 0.001), and VEINES-Sym (average 11.66 points improvement, p < 0.001) than did sclerotherapy. Postoperative pain and aesthetic concerns about the legs were the domains of the questionnaires in which the results varied the most between the treatment modalities, with worse results for sclerotherapy.ConclusionBoth polidocanol foam sclerotherapy and conventional surgery positively impact patients' quality of life after 30 days, but the improvement is more significant for patients who undergo conventional surgery.Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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