Quality of Life of Patients Treated with VenaSeal™ Versus Endovenous Laser Treatment for Varicose Veins: A Retrospective Cohort Study

Abstract

Introduction: Endovenous Laser Ablation (EVLT) has been considered the ‘gold standard’ for the treatment of varicose veins for the last two decades. The newer non thermal, Non tumescent treatment modality like VenaSealTM has shown promising results and is now considered non inferior to thermal ablation. Aim: To compare the Quality of Life (QoL) of patients with varicose veins treated with VenaSealTM and EVLT. Materials and Methods: A retrospective cohort study was carried out at the Department of Interventional Radiology of a Sahyadri Super Speciality Hospital, Pune, Maharashtra, India from January 2022 to December 2023. Adult patients (of either gender) with symptomatic venous reflux disease involving the Great Saphenous Vein (GSV) and/or Small Saphenous Vein (SSV) with associated moderate to severe varicosities (C2-C5 stages) were studied. Group I (n=30 limbs) consisted of patients who had already undergone VenaSealTM treatment for varicose veins and group II (n=30 limbs) consisted of patients who had already undergone EVLT for varicose veins. Patients in both groups were assessed before the intervention and at one week, six weeks and six months following the procedure using the 36-item Short Form Survey (SF-36) and the Aberdeen varicose veins Questionnaire (AVVQ). Categorical variables were compared using the Chi-square test. Continuous variables were compared using unpaired t-test or Mann-Whitney U test between the two treatment groups and the Kruskal-Wallis test was used within the two treatment groups. For within-group analysis, the Friedman test was used to compare pre- and postoperative values across all time points-at enrollment, six weeks and six months. A p-value of <0.05 indicates statistical significance. Results: The mean age was 48.70±12.62 years for group I and 50.46±13.00 years for group II. At baseline, no statistical difference was observed in all domains of SF-36 scores between the two groups. At six weeks, group I showed statistically higher scores in the domains of Physical Function (PF), Role limitations due to physical Problems (RP), Energy/Vitality (VT), Social function (SF) and Bodily Pain (BP) domains than group II. At six months again, no statistical difference was observed in all domains of SF-36 scores between the two groups. AVVQ scores were significantly better in the VenaSeal™ group at six weeks, but at six months, no statistical difference was noted between the two groups. Conclusion: VenaSeal™ and EVLT both provide similar QoL improvements in patients with varicose veins at six months of follow-up. VenaSeal™, however, eliminates the QoL limitations experienced by patients in the immediate and early postoperative period.

Keywords

• chronic venous insufficiency
• cyanoacrylate embolisation
• endovenous laser ablation
• varicose veins surgery