Network meta-analysis to compare VenaSeal with other superficial venous therapies for chronic venous insufficiency.
Raghu Kolluri 1 , Janice Chung 2 , Sue Kim 2 , Nibir Nath 3 , Bhoomika Bajaj Bhalla 3 , Tarun Jain 3 , Joseph Zygmunt 2 , Alun Davies 4 Affiliations expand PMID: 32063522 DOI: 10.1016/j.jvsv.2019.12.061
In this meta-analysis, the VenaSeal closure system was compared with other therapy options for the treatment of chronic venous insufficiency (CVI). The aim was to evaluate the anatomical success rate (complete closure of the treated vein within 6 months after the intervention) as the primary endpoint and health-related quality of life (HRQoL), Venous Clinical Severity Score (VCSS), pain score and adverse events as secondary endpoints.
The methods included a systematic review of journals between January 1996 and September 2018, in which randomized controlled trials (RCTs) were selected. The risk of bias and the quality of the publications were assessed. A total of 20 RCTs with 4570 patients were analyzed. The data were extracted and analyzed using mixed treatment comparisons in a network meta-analysis.
The results showed that the VenaSeal system had the highest probability of being rated best on the primary outcome measure (anatomical success). It also performed well for secondary endpoints, particularly in the reduction of postoperative pain and the occurrence of adverse events. The probability of adverse events was highest in the sclerotherapy group.
The conclusion of this study is that the VenaSeal system is a promising therapeutic option for anatomical success after 6 months in CVI patients and causes fewer adverse events (such as wound and groin infections and pulmonary embolism) compared to other interventions in the study. However, it is recommended that additional economic analyses, including cost-benefit analyses, be conducted to provide further insight for patients, payers and providers.
