The certainty of the evidence is downgraded by imprecise results (wide confidence intervals).
A Cochrane review [Abstract] 1 included 2 studies with a total of 506 subjects with an active venous leg ulcer (VLU). Both studies (VUERT and EVRA) compared endovenous treatment and compression or compression alone. The compression alone group in the EVRA trial received deferred endovenous treatment (after ulcer healing or from 6 months).
Combined endovenous ablation and compression improved time to complete ulcer healing (HR 1.41, 95% CI 1.36 to 1.47; 2 studies, n=466) and increased the proportion of ulcers healed at 90 days (RR 1.14, 95% CI 1.00 to 1.30; 2 studies, n=466) compared with compression alone, or compression with deferred endovenous treatment. There was no statistically significant difference in ulcer recurrence (RR 0.29, 95% CI 0.03 to 2.48; statistical heterogeneity I2 =78%; 2 studies, n=460) or in the number of ulcer-free days at one year in people with healed ulcers. The addition of endovenous ablation to compression was cost-effective at one year.
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