A randomized clinical trial of isolated ambulatory phlebectomy versus saphenous thermal ablation with concomitant phlebectomy (SAPTAP Trial).

Scheerders ERY, van der Velden SK, Goossens LMA, Hamann SAS, de Maeseneer MGR, Malskat WSJ et al, for the members of the SAPTAP group.

Br J Surg 2023: 110: 333–342.

Some 464 patients had ambulatory phlebectomies first; 227 were randomized to subsequent saphenous trunk ablation. Only 57 (25 per cent) of patients who had phlebectomies alone required later truncal ablation on symptomatic grounds. Overall disease-specific quality of life was similar in both groups at one year.

Comment: This revolutionary study reverses the standard treatment of truncal ablation first. Longer term outcomes are needed to test the hypothesis fully.