Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not Polidocanol foam sclerotherapy is effective in treating varicose veins as compared to conventional treatments.

STUDY DESIGN: Review of three randomized controlled trials. All three studies are published in English between 2008 – 2012.

DATA SOURCES: Three randomized control trials were found using PubMED and Medline. The sources were selected based on the outcomes measured and how the studies and outcomes mattered to patients (POEMS).

OUTCOMES MEASURED: The patients’ assessment for quality of life analyzed by logistic regression model, Chronic Venous Insufficiency Questionnaire (CVIQ), EQ-5D model, Visual analog scale and Venous clinical severity score (VCSS) and ordinal scale.

RESULTS: Three randomized controlled trials were included in the review. The first study, Rabe et al study showed statistically significant evidence in patient satisfaction (p= 0.008) in reduction of symptoms of varicose veins among the polidocanol foam sclerotherapy group as compared to liquid treatment. The second study Shadid et al showed that patient satisfaction of venous symptoms was higher in surgical intervention group (66.1%) as compared to the polidocanol foam sclerotherapy group (59.6%). However, when other factors like cost and cosmetic evidence of scars were considered; polidocanol foam sclerotherapy reflected as a better option. The third study, Ukritmanoroat demonstrates that polidocanol foam sclerotherapy has greater efficacy for venous sclerosis and venous symptoms as compared to polidocanol liquid therapy (p=0.002).

CONCLUSION: The systemic review concludes that polidocanol foam sclerotherapy is an effective treatment in treating varicose veins. When compared to different conventional treatments; there are different factors like cost, quality of life post treatment, cosmetic effects of individual treatments that should also be considered when considering the efficacy of the Polidocanol foam sclerotherapy.