Foam sclerotherapy for treatment of varicose veins

The HTA report and Cochrane SR had the broadest range of dates as they searched the literature spanning from the inception of the databases to July 201115 and January 2014,6 respectively. [...] In terms of comparators, the HTA15 and three of the SRs compared FS against any other form of varicose vein management.17,18,29 The remaining SRs compared FS against two common approaches to endovascular thermal ablation (i.e., EVLT and RFA).16 The majority of the trials involved UGFS20-25,27 although fluoroscopy-guided FS was studied in one instance26 and two studies did not specify their approac [...] Developed as a Markov model, assumptions were made on the utility values of certain health states (i.e., residual varicosities and incomplete occlusion) and on the modelling of recurrence.15 The authors of the HTA report further built their own cost-utility model to simulate the experiences of patients undergoing varicose vein treatment over a ten year time horizon.15 Employing a discrete event si [...] The remaining guidelines did not specify how recommendations were graded.3,29 Summary of Critical Appraisal A summary of the results of the critical appraisal are presented in Appendix 3. Comparative clinical effectiveness and safety of foam sclerotherapy versus other treatments for varicose veins The SR within the HTA report was overall well conducted.15 An a priori research question was defined [...] Evidence-based guidelines and recommendations for foam sclerotherapy versus other treatments for varicose veins Within the general disease guidelines, NICE3 recommends the following treatment hierarchy for the treatment of varicose veins: RFA > EVLT > UGFS > surgery based on the benefits and harms of the interventions while taking into account the quality of the underpinning evidence.