Complications Surgery Varicose Veins and Results

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Complications of varicose vein surgeries are frequently asked to the vascular surgeon.  Unfortunately, this is often not discussed at the depth it should. As in most cases of varicose veins the patient has the option of doing nothing and living the rest of his life using elastic compression.

The following table has the complication rates of various procedures that can be done for varicose veins. However, we can see that CHIVA has fewer bruises, nerve damage and relapses than most techniques. Thus, we used CHIVA hemodynamic surgery with first choice in the clinic.

As a scientific basis for the charts we took the complications in a systematic review of Cochrane, which translates clinical trials on the subject. References at the bottom of the page if there is interest.

Important Notes: 

Note 1: Studies on skin blemishes had different methods and different evaluation between techniques. For example, it seems obvious that if we look at bruises one week after the procedure we will find many, but if we wait 3 months to evaluate we will find few.

In the CHIVA x stripping studies, CHIVA had hematomas at 46% and stripping at 71%. In the Laser x stripping studies the laser had spots in 31% and surgery in 39%. This suggests that CHIVA studies were stricter or earlier in this evaluation than laser studies. Concrnig skin spots on foam, the meta-analysis revealed that in Stripping 3.2% and in the foam 4.5% of the patients had spots. The same Stripping surgery that had 71% in the CHIVA studies had 3.2% in the foam studies, making it clear that the evaluation method was different. There are studies that demonstrate early skin blemishes with 30% foam. This probably happened because some studies evaluated patients soon after and others evaluated months later when many of the spots were gone.

Note 2- About relapse CHIVA and Stripping have data up to 10 years, laser up to 5 and foam up to 2 years.

Complications of Varicose Veins
Complications and types of procedures in varicose veins
Scientific references used for analysis:
Nesbitt C, Eifell RK, Coyne P, Badri H, Bhattacharya V, Stansby G. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices. Cochrane Database Syst Rev. 2011; 20115 (10): CD005624.
Bellmunt-Montoya S, Escribano JM, Dilme J, Martinez-Zapata MJ. CHIVA method for the treatment of chronic venous insufficiency. Cochrane Database Syst Rev. 2013; 7 (7): CD009648. PMID: 23821413.
Dermody M, O'Donnell TF, Balk EM. Complications of endovenous ablation in randomized controlled trials. J Vasc Surg Venous Lymphat Disord. 2013 Oct; 1 (4): 427-36.e1.
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