Comparison of glue vs open surgery in elderly patients

Download this issue Back to summary
06 – Abstract Venous Symposium Europe 2024 [back to abstract list]
AUTHOR(S): Marta Machado1, Miguel Machado2, Arlindo Matos1, Rui Machado1
Affiliations: 1. Vascular Surgery, CUF Viseu, Viseu, Portugal. 2. General Surgery, CUF Viseu, Viseu, Portugal


BACKGROUND/AIM

Regarding elderly patients with chronic venous disease, there aren´t specific treatment guidelines. The aim of this study was to assess the efficacy and safety of interventional treatment of elderly patients and to compare glue occlusion with open surgery.

MATERIAL/METHODS

Enrolled patients were ≥70 years old with symptomatic varicose veins C3-C6 treated between 2020-2022. They were subdivided in 2 groups: one treated with glue occlusion (GO) and the other open surgery (OS). Primary outcomes were treatment success: vein obliteration at 52 weeks and venous clinical severity score (VCSS) at 12 weeks.

RESULTS

Of 107 patients treated, 37 were included (24 treated by OS; 13 by GO). A total of 48 procedures were performed (30 OS and 18 GO). The mean age was 75.4 years old; 64.9% were women. In the GO group, patients were older.

The interventional treatment in this population was effective in reducing VCSS, AVVQ (Aberdeen Varicose Vein Questionnaire), and EQ-5D scores at 12 weeks (P< 0.001). The efficacy of both methods had similar changes in VCSS, AVVQ, and EQ-5D scores after 12 weeks. However, GO is associated with a shorter length of recovery with statistically significant difference There was also a tendency to a lower grade of pain in patients treated with glue (3.8 vs 4.8). There was no clinically significant recanalization in the GO group, but 2 cases had small areas of partial recanalization. In the OS group, there was 1 case of varicose vein relapse.

CONCLUSIONS

Our results show that it is safe and effective to treat old patients with both techniques. GO is associated with shorter recovery days, even in patients with higher age.

Table I. Interventional treatment by glue occlusion or open surgery in elderly patients (>70 years); data from study population. CEAP, clinical-etiological-anatomical-pathophysiological classification; GSV, great saphenous vein; IQR, interquartile range; SD, standard deviation; SSV, small saphenous vein.