Patient-reported outcomes 5-8 years after ultrasound-guided foam sclerotherapy for varicose veins

Background: The aim was to determine the long-term (5-8 years) outcomes of ultrasound-guided foam sclerotherapy (UGFS) for varicose veins using health-related quality of life (HRQL), patient-reported outcomes (PROMs), patient satisfaction and retreatment rates. Methods: Consecutive patients undergoing UGFS between April 2004 and May 2007 were invited for review at least 5 years after treatment. Patients completed generic (Short Form 12) and disease-specific (Aberdeen Varicose Vein Symptom Severity Score, AVSS) HRQL instruments, and questionnaires enquiring about lower limb symptoms, lifestyle factors and satisfaction with treatment. Data on retreatments were recorded prospectively. Results: A total of 391 limbs in 285 patients were included (81.2 per cent response rate) at a median of 71 (i.q.r. 67-78) months following first UGFS treatment. Originally 72.1 per cent had symptomatic, uncomplicated varicose veins, 21.9 per cent had undergone surgery previously, 87.2 per cent had treatment of great saphenous veins and 19.9 per cent treatment of short saphenous veins. Disease-specific HRQL scores improved significantly at long-term follow-up, with 88.5 per cent having an improved AVSS compared with baseline. Regarding lower limb symptoms and lifestyle improvement, 62.7-93.8 per cent of patients had their pretreatment expectations met or exceeded. Overall, 82.0 per cent were very satisfied with their treatment and only 3.3 per cent were dissatisfied; 91.0 per cent would recommend the treatment to others. Some 15.3 per cent of limbs required retreatment by 5 years (Kaplan-Meier analysis). Conclusion: UGFS has durable results as reported by PROMs to at least 5 years. Only 15.3 per cent of limbs required retreatment for recurrence during follow-up.