Condition

Varicose Veins

Enlarged, twisted veins typically in the legs

2.4B
People Affected
100
Active Trials
72M
New Cases/Year
2,000
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Cyanoacrylate Glue (Venaseal)
95% Effectiveness• 90% Confidence• 78% Safety• 50 trials• 8K participants
HIGH EvidenceExcellent ValueDose: Not applicable (procedure)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
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78
DangerousModerateSafe

Time to Effect

Immediate

Duration

Single session

Response Rate

90%

Remission Rate

85%

Common Side Effects:

Localized inflammatory reaction/phlebitis: 15%
Skin discoloration: 7%
Bruising/pain: 15%
Allergic reaction to glue: 0.5%

Annual Cost of Care

Drug Cost

$0

Monitoring

$300

Side Effects

$100

Total Annual

$4,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.12

ICER

$25,000/QALY

Cost per Remission

$4,706

Cost per Responder

$4,444

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+95%
Response Rate
+90%
Remission Rate
+85%
Common Side Effects
Localized inflammatory reaction/phlebitis
+15%
Skin discoloration
+7%
Bruising/pain
+15%

Clinical Trial Phases:

Phase 4
2
Endovenous Laser Ablation (EVLA)
92% Effectiveness• 95% Confidence• 70% Safety• 19 trials• 30K participants
HIGH EvidenceExcellent ValueDose: Not applicable (procedure)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

Days to weeks

Duration

Single session

Response Rate

85%

Remission Rate

80%

Common Side Effects:

Pain/discomfort: 60%
Bruising: 50%
Numbness/paresthesia (nerve injury): 10%
Skin discoloration/hyperpigmentation: 15%
Phlebitis: 8%
Deep Vein Thrombosis (DVT): 0.5%

Annual Cost of Care

Drug Cost

$0

Monitoring

$500

Side Effects

$200

Total Annual

$4,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$20,000/QALY

Cost per Remission

$5,000

Cost per Responder

$4,706

Treatment Outcomes
Primary Outcomes
Venous Clinical Severity Score (VCSS)10 points (0-30 scale, higher is worse)
-60% (-6 points)
Leg Pain Score (NRS 0-10)6/10 (higher is worse)
-75% (-4.5 points)
Leg Heaviness/Tiredness Score (VAS 0-100)70/100 (higher is worse)
-65% (-45.5 points)
Ankle Circumference (Edema)28 cm (for affected limb)
-7% (-2 cm)
Secondary Benefits
Quality of Life (CIVIQ-20)60 points (20-100 scale, lower is better)
-20% (-12 points)
Vein Appearance Score (VAS 0-100)80/100 (higher is worse)
-50% (-40 points)
Leg Cramp Severity Score (NRS 0-10)5/10 (higher is worse)
-60% (-3 points)
Common Side Effects
Pain/discomfort
+60%
Bruising
+50%
Numbness/paresthesia (nerve injury)
+10%

Clinical Trial Phases:

Phase 4
3
Radiofrequency Ablation (RFA)
92% Effectiveness• 95% Confidence• 70% Safety• 39 trials• 28K participants
HIGH EvidenceExcellent ValueDose: Not applicable (procedure)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

Days to weeks

Duration

Single session

Response Rate

85%

Remission Rate

80%

Common Side Effects:

Pain/discomfort: 55%
Bruising: 45%
Numbness/paresthesia (nerve injury): 8%
Skin discoloration/hyperpigmentation: 12%
Phlebitis: 7%
Deep Vein Thrombosis (DVT): 0.5%

Annual Cost of Care

Drug Cost

$0

Monitoring

$500

Side Effects

$200

Total Annual

$4,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$22,000/QALY

Cost per Remission

$5,000

Cost per Responder

$4,706

Treatment Outcomes
Primary Outcomes
Venous Clinical Severity Score (VCSS)10 points (0-30 scale)
-60% (-6 points)
Pain Severity (Visual Analog Scale)7/10 points on VAS
-70% (-4.9 points)
Leg Heaviness/Fatigue Score6/10 points on symptom scale
-65% (-3.9 points)
Secondary Benefits
Quality of Life (CIVIQ-20)55 points (0-100 scale, higher is better)
+36.4% (+20 points)
Leg Circumference (at 15cm above medial malleolus)30 cm
-5% (-1.5 cm)
Patient Satisfaction with Cosmetic Appearance (VAS)3/10 points on VAS
+100% (+3 points)
Common Side Effects
Pain/discomfort
+55%
Bruising
+45%
Numbness/paresthesia (nerve injury)
+8%

Clinical Trial Phases:

Phase 4
4
Sclerotherapy (Foam/Liquid)
80% Effectiveness• 85% Confidence• 75% Safety• 4 trials• 25K participants
MODERATE EvidenceExcellent ValueDose: Polidocanol 0.5-3%, up to 10-15mL per session
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
75
DangerousModerateSafe

Time to Effect

2-6 weeks

Duration

Multiple sessions (2-4)

Response Rate

75%

Remission Rate

65%

Common Side Effects:

Hyperpigmentation: 25%
Localized pain/burning: 15%
Skin ulceration: 3%
Transient visual disturbances/headache (with foam): 7%
Allergic reactions: 0.8%
Deep Vein Thrombosis (DVT): 0.3%

Annual Cost of Care

Drug Cost

$0

Monitoring

$200

Side Effects

$100

Total Annual

$2,400

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$18,000/QALY

Cost per Remission

$3,692

Cost per Responder

$3,200

Treatment Outcomes
Primary Outcomes
Venous Clinical Severity Score (VCSS)15/30
-60% (-9 points)
Leg Pain Severity (NRS 0-10)7/10
-70% (-4.9 points)
Number of Incompetent Venous Segments3 segments
-67% (-2 segments)
Secondary Benefits
Patient Satisfaction (0-10 scale, 10=highly satisfied)3/10
+133% (+4 points)
Venous Ulcer Area6.0 cm²
-85% (-5.1 cm²)
Leg Heaviness/Fatigue (NRS 0-10)6/10
-60% (-3.6 points)
Common Side Effects
Hyperpigmentation
+25%
Localized pain/burning
+15%
Skin ulceration
+3%

Clinical Trial Phases:

Phase 4
5
Venous Stripping and Ligation
80% Effectiveness• 90% Confidence• 60% Safety• 13 trials• 40K participants
MODERATE EvidenceModerate ValueDose: Not applicable (surgery)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe

Time to Effect

2-4 weeks (recovery)

Duration

Single surgery

Response Rate

75%

Remission Rate

70%

Common Side Effects:

Post-operative pain: 80%
Bruising/swelling: 85%
Nerve damage (sensory loss): 20%
Hematoma: 15%
Infection: 3%
Deep Vein Thrombosis (DVT): 1.5%
Scarring: 100%

Annual Cost of Care

Drug Cost

$0

Monitoring

$500

Side Effects

$300

Total Annual

$8,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.07

ICER

$75,000/QALY

Cost per Remission

$11,429

Cost per Responder

$10,667

Treatment Outcomes
Primary Outcomes
Venous Clinical Severity Score (VCSS)VCSS score: 10/30 (moderate disease)
-55% (-5.5 points)
Leg Pain Severity (NRS)Numeric Rating Scale (NRS) for pain: 7/10
-64% (-4.5 points)
Leg Heaviness/Fatigue (VAS)Visual Analog Scale (VAS) for leg heaviness: 8/10
-62.5% (-5 points)
Leg Edema (Ankle Circumference)Ankle circumference: 26 cm (affected leg)
-7.7% (-2 cm)
Secondary Benefits
Disease-Specific Quality of Life (CIVIQ-20)CIVIQ-20 score: 65/100 (higher score indicates worse QoL)
-24.6% (-16 points)
Cosmetic Satisfaction (Patient-Reported)Patient satisfaction with leg appearance (0-10 scale): 3/10
+100% (+3 points)
Physical Functioning (SF-36 subscale)SF-36 Physical Functioning subscale: 45/100
+20% (+9 points)
Common Side Effects
Post-operative pain
+80%
Bruising/swelling
+85%
Nerve damage (sensory loss)
+20%

Clinical Trial Phases:

Phase 4
6
Compression Stockings
40% Effectiveness• 90% Confidence• 95% Safety• 46 trials• 15K participants
MODERATE EvidenceExcellent ValueDose: 20-30 mmHg, 30-40 mmHg
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
95
DangerousModerateSafe

Time to Effect

Immediate (symptom relief)

Duration

Lifetime (as needed)

Response Rate

40%

Remission Rate

%

Common Side Effects:

Discomfort/tightness: 30%
Skin irritation/itching: 15%
Difficulty donning/doffing: 40%

Annual Cost of Care

Drug Cost

$0

Monitoring

$100

Side Effects

$50

Total Annual

$600

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.02

ICER

$10,000/QALY

Cost per Responder

$1,500

Treatment Outcomes
Primary Outcomes
Leg Heaviness/Pain6.5/10 on VAS
-40% (-2.6 points)
Leg Edema (Ankle Circumference)27.5 cm
-5% (-1.4 cm)
Venous Clinical Severity Score (VCSS)10/30 on VCSS
-30% (-3 points)
Secondary Benefits
Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-20 Score)45/100 on CIVIQ-20
-20% (-9 points)
Leg Fatigue6.0/10 on VAS
-35% (-2.1 points)
Frequency of Aching Legs6 days/week
-50% (-3 days/week)
Common Side Effects
Discomfort/tightness
+30%
Skin irritation/itching
+15%
Difficulty donning/doffing
+40%

Clinical Trial Phases:

Phase 4