COMPARISON OF ULTRASOUND-GUIDED FOAM SCLEROTHERAPY AND ENDOVENOUS LASER ABLATION FOR GREAT SAPHENOUS VEIN INCOMPETENCE IN CEAP C2–C3 PATIENTS: AN INTEGRATIVE REVIEW

Abstract

Great saphenous vein incompetence is a frequent cause of symptomatic varicose veins and edema in clinical classes C2 and C3 of the Clinical, Etiological, Anatomical, and Pathophysiological classification. This integrative review compared the effectiveness, safety, and durability of ultrasound-guided foam sclerotherapy and endovenous laser ablation. PubMed/MEDLINE, BVS/LILACS, and SciELO were searched from January 2021 to August 9, 2026, using terms related to the great saphenous vein, sclerotherapy, foam, endovenous laser, and venous insufficiency. After deduplication and screening, 16 publications were synthesized. Laser ablation achieved more sustained anatomical occlusion and lower recanalization and reintervention rates, particularly during long-term follow-up. Foam treatment was simpler, avoided tumescent anesthesia, and could be repeated, but more often required additional sessions. Both approaches reduced symptoms and improved quality of life, while serious adverse events were uncommon. Treatment selection should consider vein diameter, anatomy, anesthetic risk, availability, and patient preference. Although direct evidence restricted to CEAP C2–C3 remains limited, the overall evidence favors laser when durability is the priority; foam remains a valid option when minimal invasiveness and procedural flexibility are decisive.