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Comparison of 12-W versus 14-W endovenous laser ablation in the treatment of great saphenous varicose veins: 5-year outcomes from a randomized controlled trial

Samuel, Nehemiah; Wallace, Tom; Carradice, Daniel; Mazari, Fayyaz AK; Chetter, Ian C.

Authors

Nehemiah Samuel

Tom Wallace

Fayyaz AK Mazari



Abstract

Introduction: Endovenous laser ablation (EVLA) has been demonstrated to be an effective treatment for lower limb varicose veins in the short and midterm results. This study reports the 5-year outcomes of EVLA technique at different power settings. Methods: Patients with primary symptomatic, unilateral varicose veins secondary to saphenofemoral junction (SFJ) incompetence and great saphenous vein (GSV) reflux were recruited and randomized to either 12W (intermittent laser withdrawal) or 14W (continuous laser withdrawal). They were assessed at baseline, 1, 6, 12, 52, 104 weeks, and 5 years. Outcome measures included: Venous Clinical Severity Score (VCSS), pain scores, time taken to return to normal functions, complications, recurrence, quality of life (QoL), and duplex ultrasound findings. Results: 76 consecutive patients, M: F 30:46, median age 54(IQR: 37.3-59) years were randomized. Intragroup analysis: Significant improvement was seen in both groups in VCSS, pain scores, Aberdeen varicose vein questionnaire (AVVQ) scores, Shortform-36 (SF-36) and Euroqol (EQ-5D) domains over the follow-up period (P < 0.05). Intergroup analysis: Over 5 years, clinically recurrent varicosities and duplex detected SFJ incompetence was less frequent and patient satisfaction with cosmetic outcome significantly higher in the 14W group (P < 0.05). There was no significant difference between the groups in duration of procedure, postoperative pain scores, return to normal functioning, complications, VCSS, disease specific (AVVQ) and generic (SF36, EQ-5D) QoL measures (P > 0.05). Conclusion: Late outcomes following EVLA were superior for the 14W continuous power settings achieving better long term venous occlusion and lowered recurrence rates without increasing post-operative morbidity. Hence 14W continuous setting should be the energy delivery mode of choice.

Citation

Samuel, N., Wallace, T., Carradice, D., Mazari, F. A., & Chetter, I. C. (2013). Comparison of 12-W versus 14-W endovenous laser ablation in the treatment of great saphenous varicose veins: 5-year outcomes from a randomized controlled trial. Vascular and endovascular surgery, 47(5), 346-352. https://doi.org/10.1177/1538574413487265

Journal Article Type Article
Acceptance Date Jul 18, 2013
Online Publication Date May 3, 2013
Publication Date Jul 1, 2013
Journal Vascular and Endovascular Surgery
Print ISSN 1538-5744
Electronic ISSN 1938-9116
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 47
Issue 5
Pages 346-352
DOI https://doi.org/10.1177/1538574413487265
Keywords Surgery; Cardiology and Cardiovascular Medicine; General Medicine
Public URL https://hull-repository.worktribe.com/output/432571
Publisher URL http://journals.sagepub.com/doi/10.1177/1538574413487265