Endovenous laser ablation of saphenous vein – mid-term results confirm permanent closure and possibility to treat more lesions in one procedure
Authors:
T. Honěk; J. Honěk; V. Horváth; M. Šlais; M. Vítovec; O. Stehno; P. Šedivý; T. Kneifl; V. Fabián; P. Šebesta
Authors‘ workplace:
Elektrotechnická fakulta, ČVUT, Praha
; Avicena-chirurgie s. r. o., Nemocnice Malvazinky, Praha
Published in:
Rozhl. Chir., 2020, roč. 99, č. 7, s. 299-303.
Category:
Original articles
doi:
https://doi.org/10.33699/PIS.2020.99.7.299–303
Overview
Introduction: Endovenous Laser Ablation (EVLA) is a common alternative to surgical treatment of varicose veins. The aim of our study was to demonstrate that laser occlusion is durable, that we can treat all patients in a one day setting, even with veins >10mm in diameter, and that multiple EVLAs can be done at the same time.
Methods: In the period from 1/2017 to 12/2019 EVLA was performed in a total of 1551 consecutive patients with varicose veins and ultrasonographically documented venous reflux. The mid-term results were evaluated in a group of patients operated from 1/2017 to 6/2017 (316 pts.). We compared a risk group that consisted of patients with veins >10mm in diameter (40 pts.) with a control group (the remaining 276 pts.). Patients with veins >10mm are traditionally considered as candidates for conventional surgery.
Results: The catheter-based method enabled us to perform more ablations in one procedure. In 2019 we performed 1.44 EVLA procedures per patient. There was only one postoperative follow-up visit, indicating an uncomplicated postoperative course, in 87.5% of patients of the risk group. In the control group 100% of patients had only one follow-up visit including ultrasound examination, showing an uncomplicated postoperative course (p<0.001). There was no difference in the incidence of complications. Ultrasonographic follow-up was performed in the risk group. Veins larger in diameter revealed complete disintegration early, but at the end of the follow-up period (mean 33±6 months) they disappeared completely.
Conclusion: The study showed good mid-term results of EVLA of the saphenous vein in the outpatient setting and the feasibility of performing multiple ablations in a non-selected group of patients using local anaesthesia. Laser destruction of the vein was shown to be permanent. Perfect familiarity with the diagnostic procedure using ultrasonography and early patient follow-up are required to achieve reproducibility.
Keywords:
endovenous laser ablation – chronic venous insufficiency – mid-term results
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