Initial Experience in Endovenous Laser Ablation (EVLA) of Varicose Veins Due to Small Saphenous Vein Reflux
- 1 May 2007
- journal article
- Published by Elsevier BV in European Journal of Vascular and Endovascular Surgery
- Vol. 33 (5), 614-618
- https://doi.org/10.1016/j.ejvs.2006.10.030
Abstract
ObjectiveConventional surgery for varicose veins due to small saphenous reflux is associated with high recurrence rates (up to 50%), many resulting from inadequate surgery. This prospective audit examines the safety and efficacy of EVLA in the treatment of this.Method65 patients (68 limbs) with varicosities due to primary or recurrent sapheno-popliteal junction (SPJ) and small saphenous vein (SSV) reflux underwent out-patient EVLA (810nm diode laser). The SSV was ablated from mid-calf to the SPJ. Symptomatic improvement (Aberdeen Varicose Vein Severity Score [AVVSS]), time to return to normal activity, post-EVLA analgesic requirements, and complications were recorded.ResultsDuplex ultrasound follow-up (median 6-months) confirmed abolition of SPJ/SSV reflux in all limbs following a median total laser energy delivery of 1131J (IQR 928-1364) at an energy density of 66.3 Joules/cm (IQR 54.2–71.6). AVVSS improved from 15.4 (IQR 11.8–19.7) to 4.6 (IQR 3.2–6.7) at three months (p<0.001). Median analgesia requirement was 3 days (23% [15/65] patients required none) and the median time to normal activity was 0 (0–4) days (65% [42/65] returning to normal daily activity immediately). There were no instances of skin burns or DVT but 3 patients (4.4%) developed transient cutaneous numbness (sural nerve). 98% (64/65) patients would undergo EVLT again.ConclusionsEVLA abolished SPJ/SSV reflux in all limbs. This is likely to be more effective than conventional surgery, although long-term follow up is required. Data from a randomised control trial would be desirableKeywords
This publication has 15 references indexed in Scilit:
- Systematic review of endovenous laser treatment for varicose veinsBritish Journal of Surgery, 2005
- Neovascularization and recurrent varicose veins: more histologic and ultrasound evidenceJournal of Vascular Surgery, 2004
- Combined endovascular laser with ambulatory phlebectomy for the treatment of superficial venous incompetence: a 2?year perspectiveJournal of Cosmetic and Laser Therapy, 2004
- Endovenous Laser Ablation of the Saphenous Vein for Treatment of Venous Insufficiency and Varicose Veins:Early Results From a Large Single-Center ExperienceJournal of Endovascular Therapy, 2004
- Recurrence after varicose vein surgery: a prospective long-term clinical study with duplex ultrasound scanning and air plethysmographyJournal of Vascular Surgery, 2003
- Endovenous Laser Treatment of Saphenous Vein Reflux: Long-Term ResultsJournal of Vascular and Interventional Radiology, 2003
- Initial experiences in endovenous treatment of saphenous vein refluxJournal of Vascular Surgery, 2002
- Treatment of Varicose Long Saphenous Veins with Sclerosant in Microfoam Form: Long-Term OutcomesPhlebology: The Journal of Venous Disease, 2000
- Endovenous management of saphenous vein refluxJournal of Vascular Surgery, 2000
- Neovascularisation is the principal cause of varicose vein recurrence: Results of a randomised trial of stripping the long saphenous veinEuropean Journal of Vascular and Endovascular Surgery, 1996