Clinical effectiveness and cost-effectiveness of minimally invasive techniques to manage varicose veins: a systematic review and economic evaluation

Systematic review, network meta-analysis and exploratory cost-effectiveness model of randomized trials of minimally invasive techniquesversussurgery for varicose veins

“…28 The full results of the univariate sensitivity analysis are reported elsewhere. 23 The results were not sensitive to uncertainty associated with most parameters, with the exception of the disutility associated with post-operative treatment, and the model time horizon. The results for FS compared to surgery were potentially sensitive to disutility associated with treatment, a parameter derived from the network meta-analysis of reported pain at approximately 10 days (see Figure 6).…”

“…23 All of the effectiveness analyses presented here used only technical rather than symptomatic recurrence data, so the true proportion of treated individuals who are likely to present with symptoms of recurrence requiring retreatment is not certain. The rates of technical recurrence reported here are therefore higher than those encountered in clinical practice because nonsymptomatic patients would not present, even if they were experiencing technical recurrence.…”

“…The findings on initial failure and retreatment, symptomatic recurrence and retreatment for recurrence, given in the full report 23 , are affected by a high degree of uncertainty due to the relative infrequency with which such data were reported, as well as the limitations of the primary studies' reporting of these data. Based on projections from trial data the long-term risk of a technical recurrence is less for all the minimally invasive treatments compared with surgery, although the time to treatment failure curves are quite similar.…”

Cost-effectiveness of ultrasound-guided foam sclerotherapy, endovenous laser ablation or surgery as treatment for primary varicose veins from the randomized CLASS trial

“…These have revealed differing results. One found EVLA and radiofrequency ablation (RFA) to be the most cost-effective 2 , another found daycase EVLA to be cost-effective 3 , whilst a third study found UGFS to be the most cost-effective 4 .…”

The Study, Clinical Implications and Solutions for Failed Varicose Vein Surgery With Recurrent Venous Ulcers: An Analysis of 12 Patients With Duplex Scan Correlated With Intra Operative Findings at Second Surgery

“…[5] Currently available evidence suggests there is little to choose between the minimally invasive techniques in terms of efficacy or cost and each offers a viable, clinically effective alternative to stripping. [11] Venous ulcer could be satisfactory treated by the total removal of the periulcer reflux. [12] Correction of reflux of the superficial and perforator system remains useful even with the advent of endovenous laser treatment.…”