Randomized clinical trial comparing bipolar coagulating and standard great saphenous stripping for symptomatic varicose veins

Background: Typical side-effects of saphenous stripping for symptomatic varicose veins include painful thigh haematomas, which a new bipolar coagulating electric vein stripper (EVS) may reduce. Methods: In a randomized, single-blind trial at three vascular centres, 99 patients were assigned to EVS and 101 to conventional stripping. The primary outcome was postoperative pain at rest and following physical exercise (climbing stairs). Haematomas were quantified by ultrasonography. Further endpoints were duration of postoperative compression, sick leave and quality of life (measured by the Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ) and Short Form 36 (SF-36®)). Results: Mean resting visual analogue scale for pain 24 h after surgery was 1·6 in the EVS group and 3·3 in the conventional stripping group (mean difference 1·7, 95 per cent confidence interval (c.i.) 1·4 to 1·9, P < 0·001). Mean ratings following exercise were 3·3 and 5·5 (mean difference 2·3, 95 per cent c.i. 2·0 to 2·6, P < 0·001) respectively. No patient in the EVS group had a measurable thigh haematoma, compared with 74 patients after conventional stripping (P < 0·001). The EVS significantly decreased the length of compression therapy and sick leave, and produced superior CIVIQ and SF-36 ratings. Conclusion: The EVS was safe and effective in avoiding painful haematomas following varicose vein surgery. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.