Efficacy of Endovenous Treatments for Superficial Venous Disease in Relation to Symptomatic Pain and Quality of Life

Improvement in postprocedural pain in patients with superficial venous disease remains controversial. This study aims to evaluate the effectiveness of endovenous treatment on postprocedural pain by assessing symptom reduction in association with vein diameter.

Methods:

This study was conducted at a private office based lab varicose vein clinic, which implemented a standardised care pathway for treating superficial venous disease across three locations in the UK. Consecutive patients (2020-2023) receiving endovenous radiofrequency ablation of truncal veins and foam sclerotherapy of varicosities under local anaesthesia completed the Aberdeen Varicose Vein Questionnaire (AVVQ) before and at their 3-month post-procedure follow-up appointment.  

Results:

A total of 1075 (74% female; average age 52, range: 21-86) completed the AVVQ prior to intervention at their one-stop pre-assessment clinic and subsequently underwent endovenous treatment. A total of 706 patients (66%) reported pain from their varicose veins before treatment, with 87% (614/706) reporting an improvement postprocedure (mean difference: -1.4, -3 to 2; P< 0.0001). There was no correlation between vein diameter at presentation (mean diameter: 3.6mm, 1 to 13mm) with pre-procedural pain (r=0.011, P=0.35), or post procedural pain (r=0.021, P=0.248).

Conclusions:

A significant number of patients with superficial venous disease experience pain. Vein diameter does not correlate with pain, and endovenous treatment with radiofrequency ablation and foam sclerotherapy improves pain, irrespective of vein size. Patients with superficial venous disease should be offered treatment to improve symptomatic pain, regardless of vein diameter.