At five years, surgery for varicose veins and thermal ablation by laser edge out ultrasound-guided foam sclerotherapy for patient quality of life, according to a UK randomised trial.

Both provide modestly better quality of life than foam sclerotherapy for patients, and laser treatment also emerged as more cost-effective than surgery, researchers report in the New England Journal of Medicine.

The findings show that the trends seen when the researchers reported their six-month results persisted.

“All three treatments improve quality of life. But the effect was greater with laser and surgery compared to foam,” says chief author Dr Julie Brittenden of the University of Glasgow.