Treating varicose veins with vein-stripping surgery is associated with higher costs than closing the veins with heat, according to a study at Henry Ford Hospital in Detroit.
"Cost-effectiveness is an important factor to consider when comparing different treatments for varicose vein disease," says Judith C. Lin, M.D., vascular surgeon and lead author of the study. "And these two types of treatment have similar effectiveness."
The study will be presented March 13 at the 41st Annual Symposium of the Society for Clinical Vascular Surgery in Miami.
The current treatment of choice over surgery for physicians and patients with superficial venous insufficiency and varicose veins, whose veins aren't strong enough to pump blood back to the heart, is endovenous catheter ablation. This procedure involves targeting heat energy inside a vein to seal it. Heat may be created by a laser (endovenous laser ablation, or EVLA) or by radio waves (endovenous radiofrequency ablation, or RFA). With the diseased vein sealed, other healthy veins carry blood from the leg, re-establishing the normal flow.
The retrospective study of hospital and office costs was performed by analyzing costs of patients undergoing stripping of a major leg vein, RFA, and EVLA between January 1, 2010 to December 31, 2011 at hospitals and physician's offices within the Health Ford Health System.
Costs were divided into charges, net revenue, total cost, variable cost, direct cost, variable contribution margin, program contribution margin, and profit or loss categories. All costs were normalized to 2010 and 2011 values.
A total of 152 vein procedures in 2010, and 156 cases in 2011 were performed in an office setting; 73 vein procedures in 2010 and 71 cases in 2011 were done in a hospital operating room.
In 2010, higher costs per case were consistently seen in vein stripping ($5458) and vein ablation ($4884) performed in the operating room, as compared to RFA ($1074) and EVLA ($1534) performed in the office.
EVLA and RFA are highly effective, minimally invasive procedures, usually performed in a doctor's office, explains Dr. Lin. No general anesthesia or hospitalization is needed. There is very little scarring, and patients can resume normal activities immediately.