The value of different forms of treatment for varicose veins

Summary In a controlled clinical investigation 516 patients with previously untreated saphenous varices were divided into three treatment groups according to a stratified group comparative design. The patients in treatment group 1 underwent a radical operation under full anaesthesia; the patients in group 2 were treated by means of minor operations followed by injection/compression therapy; the patients in group 3 were treated by means of injection/compression therapy alone. The results were evaluated both objectively and subjectively 3 months and 3 years after treatment, the follow-up being 100 per cent and 98.1 per cent complete at those times. With regard to the period of disability among those patients with jobs outside the home (63.8 per cent), there was a statistically significant difference between the three groups, the median period of disability being 14.2, 7.6 and 0 days respectively. In all three treatment groups the results were worse after 3 years than after 3 months, but the difference was significantly less following radical operation than after combined treatment, and significantly less following combined treatment than after injection/compression therapy alone. The patients were randomized and treated by the author and the results of treatment were evaluated by the author and partly controlled by another investigator. It is concluded that the primary treatment for incompetence of the saphenous veins should be a radical operation.