Impact of treatment of varicose veins with polidocanol foam compared to conventional surgery on quality of life

ABSTRACT Background and objective Lower limb varicose veins are very prevalent and there are several treatment options available, including conventional surgery and polidocanol foam sclerotherapy. Few studies analyze therapeutic modalities based on PROMs (patient-reported outcome measures). The aim of this study was to evaluate the impact of treatment with polidocanol foam sclerotherapy compared to conventional surgery in a large sample, based on an analysis of PROMs. Methods This was a prospective, observational, and qualitative study of 205 patients who underwent varicose vein treatment with polidocanol foam sclerotherapy (57 patients - 90 legs) or conventional surgery (148 patients - 236 legs). Patients were assessed preoperatively and 30 days after the procedure using venous disease severity scores (VCSS) and specific venous disease quality of life questionnaires (VEINES-QoL/Sym). Results Both treatments promoted a significant improvement in VCSS and VEINES 30 days after the procedure (p < 0.05). However, surgery promoted a greater improvement in VCSS (on average 4.02 points difference, p < 0.001), VEINES-QoL (8 points difference, p < 0.001) and VEINES-Sym (on average 11.66 points better, p < 0.001) compared to sclerotherapy. Post-operative pain and aesthetic concern about the legs were the domains of the questionnaires that had the greatest impact on this difference between the two types of treatment, generating worse results with sclerotherapy. Conclusion Polidocanol foam sclerotherapy and conventional surgery have a positive impact on quality of life after 30 days, but there is a more significant improvement in patients undergoing conventional surgery.