Reverse Foam Sclerotherapy of the Great Saphenous Vein with Sapheno-Femoral Ligation Compared to Standard and Invagination Stripping: a Prospective Clinical Series

Objectives: Comparison of Reverse Foam Sclerotherapy of the great saphenous vein (GSV) combed with sapheno-femoral junction (SFJ) ligation to standard (Babcock) stripping and invagination (Pin) stripping in a prospective clinical series. Design: Prospective clinical series. Materials and methods: 90 consecutive limbs of 82 patients with incompetence of the GSV resulting in varicose veins were prospectively randomised into 3 groups of 30, treated by SFJ ligation and either reverse foam sclerotherapy, standard stripping or invagination stripping of the GSV. Outcomes were assessed post-operatively and at 2-weeks follow-up. Peri-operative blood loss (24 hrs), analgesic requirement, bruising and residual varicosities were assessed. Bruising was assessed by both patients and independent assessors using questionnaires. Results: SFJ ligation plus reverse foam sclerotherapy of the GSV was associated with significantly less blood toss, bruising and post-op discomfort than either of the stripping techniques. (p<0.001, Mann-Whitney). Conclusion: Standard stripping of the GSV and invagination stripping are not associated with major discomfort and problems in the early post-operative period. SFJ ligation and GSV reverse foam sclerotherapy yielded greater patient satisfaction with less post-op bruising and discomfort and reduced analgesic requirements. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.