Long-term efficacy of sclerosing foam combined with endovenous laser treatment for varicose veins of the lower extremities

Background: This investigation aimed to assess the long-term effectiveness and symptomatic manifestations of the combined therapy of sclerosing foam and endovenous laser ablation (ELA) for treating lower-extremity varicose veins. Materials and methods: In this study, we examined 2,118 patients (2,324 limbs) diagnosed with varicose veins in one or both lower extremities. These patients were treated at our center between January 2019 and December 2021. All individuals underwent the combined treatment of sclerosing foam and ELA. We closely monitored the occlusion status of the great saphenous vein (GSV) trunk and its tributaries, along with the postoperative therapeutic outcomes and symptomatic presentations. The average follow-up duration was 41.3 months, and data were collected via outpatient appointments and telephone follow-up inquiries. Results: The success rate of the treatment procedure was 100%. Based on the outcomes of continuous follow-up spanning from 1 to 3 years after the surgery, among the 2,324 legs, 16 legs still required repeated foam sclerotherapy for varicose veins, 2 legs exhibited venous edema, and 11 legs showed skin pigmentation. At one week and one year after the procedure, incomplete closure of the GSV trunk (characterized by patency, blood flow, and reflux) was observed in 1.8% (38 limbs) and 1.1% (23 limbs), respectively. Nineteen patients with local recurrence of varicose veins decided not to undergo further treatment. Conclusion: The long-term follow-up data demonstrated that the combination of sclerosing foam and endovenous laser was highly efficacious in treating varicose veins. The main postoperative symptoms included the requirement for additional sclerosing foam injections, skin pigmentation, pain and tissue induration.