Venous interventions reduce the risk of lymphedema in chronic venous insufficiency.

INTRODUCTION

Chronic venous insufficiency (CVI) significantly increases the risk of developing secondary lymphedema and related infections. This study tested the hypothesis that lower-extremity venous procedures can reduce the 5-year incidence of lymphedema in adults with CVI.

METHODS

A multicenter retrospective cohort study was conducted using the TriNetX Research Network. Adults (⩾ 18 years) diagnosed with CVI between Jan 1, 2005, and Jan 1, 2020, were identified and followed for at least 5 years. Patients were stratified into those undergoing venous procedures, including saphenous vein ligation, phlebectomy, sclerotherapy, and endovenous ablation, and matched controls managed without intervention. Propensity score matching was performed 1:1 on demographics, comorbidities, and infection-related variables. The primary outcome was new-onset lymphedema, assessed using Cox proportional hazards models and Kaplan-Meier analysis.

RESULTS

After matching, 17,703 patients were included in each cohort. At 5 years, new-onset lymphedema occurred in 5.1% of controls versus 4.0% of patients who underwent venous procedures (hazard ratio [HR] 1.26, 95% CI 1.14-1.40). Phlebectomy showed the strongest association with risk reduction (4.0% vs 1.5%; HR 2.60, 95% CI 1.33-5.06), followed by varicose vein sclerotherapy (5.3% vs 3.6%; HR 1.49, 95% CI 1.02-2.16).

CONCLUSIONS

Venous interventions may reduce the risk of developing lymphedema in patients with chronic venous insufficiency.