Treatment of Superficial Venous Incompetence with a Hemodynamic Technique on an Outpatient Basis: The SAVAS Technique

Three techniques to treat venous incompetence on an outpatient basis were compared in 138 limbs [107 patients) with superficial venous incompetence. They were treated with the dentist's technique (DT) [Group A, 44 limbs], compres sion sclerotherapy (CS) [Group B, 45 limbs], or the SAVAS [ sectionnement en Ambulatoire des Varices Avec Sclerotherapie] technique [Group C, 49 limbs]. All patients were followed up (five years) with ambulatory venous pressure (AVP) measurements and color duplex scanning. DT consisted of the sectioning under local anesthetic of incompetent veins. CS was done by injecting polidocanol 3% with compression applied for four weeks. The SAVAS was done with a combination of DT and CS with sectioning of the incompetent veins under local anesthetic and retrograde injection in the distal veins of polidocanol 3%. This type of retrograde injection perfuses only incompetent veins. After five years there was a significantly lower refilling time (RT) with AVP in the SAVAS group (average of twenty seconds). RT was 12.5 seconds in group B and fifteen in A. The number of significantly incompetent residual veins was on the average 0.9 in the SAVAS group, significantly lower than in the other two groups. The average cost per treated limb was significantly lower is the SAVAS group. In conclusion, after a five-year follow-up, the SAVAS technique was more effective, its hemodynamic value was superior to DT and CS, and its costs were lower.