Endovenous laser ablation of the great saphenous vein versus high ligation: long-term results

Endovenous laser therapy (EVLT) for greater saphenous vein (GSV) insufficiency is a relatively new method of treatment only recently made available in Iran. This is the first long-term randomized trial comparing EVLT with high ligation of saphenous vein (HLS) in the Iranian population. Sixty-five pa...

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Bibliographic Details
Published in:Lasers in medical science 2014-03, Vol.29 (2), p.765-771
Main Authors: Mozafar, Mohammad, Atqiaee, Khashayar, Haghighatkhah, Hamidreza, Taheri, Morteza Sanei, Tabatabaey, Ali, Lotfollahzadeh, Saran
Format: Article
Language:English
Subjects:
Adult
Dentistry
Endovascular Procedures
Female
Follow-Up Studies
Humans
Laser surgery
Laser Therapy - adverse effects
Laser Therapy - methods
Lasers
Ligation
Male
Medicine
Medicine & Public Health
Middle Aged
Optical Devices
Optics
Original Article
Patient Satisfaction
Photonics
Plastic surgery
Quantum Optics
Saphenous Vein - physiopathology
Saphenous Vein - surgery
Surgical outcomes
Treatment Outcome
Varicose Veins - surgery
Vein & artery diseases
Venous Insufficiency - surgery
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Summary:Endovenous laser therapy (EVLT) for greater saphenous vein (GSV) insufficiency is a relatively new method of treatment only recently made available in Iran. This is the first long-term randomized trial comparing EVLT with high ligation of saphenous vein (HLS) in the Iranian population. Sixty-five patients met the inclusion criteria and were divided into homogenous treatment groups of EVLT ( n  = 30) or HLS ( n  = 35). Clinical severity, etiology, anatomy, pathophysiology (CEAP) classification and Aberdeen Varicose Vein Symptom Severity Scores (AVSS) were used to determine disease severity and symptoms before and after the procedure in both groups. Outcome was measured by the rate of recurrence as shown in Doppler ultrasonography evaluation. Follow-up was conducted 1 week and 3, 6, 12, and 18 months after the intervention. The occlusion rate of GSV was similar in both groups (93.6 % for EVLT, 88.3 for HLS) at 18 months of follow-up. The median CEAP score showed a dramatic decrease in both groups after 1 week which was sustained for the rest of the study. The Aberdeen Varicose Vein Symptom Severity score was significantly lower in the EVLT group at 12 and 18 months of follow-up. There was no significant difference in patient satisfaction in both groups. Our findings show that EVLT may offer a better long-term relief of symptoms. This, alongside its better cosmetic outcome, and less invasive anesthesia requirements may make it the favorable choice for treatment of GSV insufficiency.
ISSN:0268-8921
1435-604X
DOI:10.1007/s10103-013-1389-z