Cost analysis of endovenous catheter ablation versus surgical stripping for treatment of superficial venous insufficiency and varicose vein disease.

Background: Due to its clinical efficacy and faster recovery, endovenous catheter ablation has become the treatment of choice over surgical intervention for patients with varicose veins secondary to saphenous vein reflux.

Methods: A retrospective analysis of costs was performed on patients undergoing vein stripping, endovenous radiofrequency ablation (RFA), endovenous laser treatment (EVLT), and phlebectomy of varicosities at a community hospital and a tertiary care hospital in southeastern Michigan.

Results: In 2010 to 2011, higher costs resulted in a net loss per case for vein stripping, RFA, and phlebectomy procedures performed in the operating room for the community hospital. In contrast, RFA, EVLT, and phlebectomy procedures performed in an office setting resulted in a net profit for the tertiary care institution.

Conclusions: Treatment of saphenous vein reflux and varicose vein disease with vein stripping was associated with higher costs than RFA and EVLT. Endovenous RFA performed in the operating room is associated with net loss per case vs office-based interventions. At present, catheter-based interventions in an office setting can be considered the more cost-effective method for treating patients with superficial venous reflux and varicose veins.