Evaluation of cost-effectiveness and thrombotic markers of the varice techniques' treatment in the public health system

Abstract

Chronic venous disease (CVD) is a highly prevalent entity in which the main pathophysiological factors are venous reflux and chronic deep vein obstruction, determining chronic venous hypertension in the lower limbs. Among the available treatments, the surgical and intravenous treatments stand out. These treatments aim to correct venous hypertension through intervention on varicose veins by surgical removal of the diseased saphenous vein or its obliteration through minimally invasive techniques, which include foam sclerotherapy and laser or radiofrequency thermoablation. The standard surgical treatment of varicose veins, which is surgical ligation and removal of the affected vein, invariably requires several weeks of recovery with late return to usual activities, whereas in minimally invasive treatments patients recover faster and return to work early. Faced with so many alternatives to the treatment of chronic venous disease nowadays, it is necessary that these techniques may be studied and compared, not only as to their efficacy, but also as to their cost-benefit, influence on quality of life, economic impact on the public health system and even in the social security system. Although uncommon, venous thromboembolism (VTE) is a serious complication of the surgical or intravenous treatment of varicose veins. However, the concern with its occurrence is justified, since thromboembolic complications result in high rates of morbidity and mortality in a context of treatment of a non-lethal disease. In another aspect of the present study, we will investigate the markers of venous thrombosis in the peripheral blood, which may aid in the diagnosis or detection of cases more susceptible to the incidence of VTE, with evident potential benefits in the clinical management of these patients. This study therefore seeks to take a comprehensive approach to the new techniques of varicose vein treatment, investigating at the same time clinical, surgical and health management issues, and venous thrombosis mechanisms, both of which may provide improvements in social, economic and quality of service aspects. (AU)