G. Smith
Evolution of an endovenous laser ablation practice for varicose veins
Smith, G.; Samuel, N.; Wallace, T.; Carradice, D.; Smith, George; Mazari, F.; Chetter, I.
Authors
N. Samuel
T. Wallace
Professor Daniel Carradice D.Carradice@hull.ac.uk
Senior Lecturer in Vascular and Endovascular Surgery
Mr George Smith George.Smith@hull.ac.uk
Senior Lecturer
F. Mazari
Professor Ian Chetter I.Chetter@hull.ac.uk
Professor of Vascular Surgery
Abstract
Objective We aimed to assess the evolution of an endovenous laser ablation (EVLA) practice in the management of varicose veins in a university teaching hospital vascular surgical unit, over five years. Methods This was a retrospective review of a prospectively collected database of patients undergoing EVLA for great saphenous vein incompetence and followed up for a year. For inter- and intragroup comparison, patients were divided into three groups: group A: endovenous access generally established at the perigenicular level (n = 105); group B: when practice changed to gain access at lowest point of demonstrable reflux (n = 70); and group C: when tumescence delivery changed from manual injections to delivery via peristaltic pump (n = 49). Outcomes including pain scores, time taken to return to normal functioning, quality of life (QoL), venous clinical severity scores (VCSS) and complication rates were evaluated. Results Intergroup analysis: increase in the length of vein treated and laser density delivered was observed over time, even as median procedure duration decreased (P < 0.001). An increase in sensory disturbance was noticed in group C (P = 0.047) while better Aberdeen Varicose Vein Questionnaire (AVVQ) (P = 0.004), SF-36® physical domains (P < 0.05) and patient satisfaction with treatment (P = 0.025) were recorded in the same group at 52 weeks. No significant difference was observed in technical failure, pain scores, return to normal functioning, VCSS and recurrence rates post-intervention. Intragroup analysis: QoL measures (AVVQ, SF-36®, EQ-5D) and VCSS scores demonstrated significant improvement at 12 and 52 weeks compared with baseline (P < 0.05). Conclusions Increase in length of vein treated and energy delivery seems to improve short-term outcomes; however, operators need to be wary of a possible concurrent increase in paraesthetic complications.
Citation
Samuel, N., Wallace, T., Carradice, D., Smith, G., Mazari, F., & Chetter, I. (2013). Evolution of an endovenous laser ablation practice for varicose veins. Phlebology, 28(5), 248-256. https://doi.org/10.1258/phleb.2011.011103
Journal Article Type | Article |
---|---|
Acceptance Date | May 3, 2013 |
Online Publication Date | Feb 22, 2012 |
Publication Date | 2013-08 |
Journal | Phlebology |
Print ISSN | 0268-3555 |
Publisher | SAGE Publications |
Peer Reviewed | Peer Reviewed |
Volume | 28 |
Issue | 5 |
Pages | 248-256 |
DOI | https://doi.org/10.1258/phleb.2011.011103 |
Keywords | Cardiology and Cardiovascular Medicine; General Medicine |
Public URL | https://hull-repository.worktribe.com/output/432576 |
Publisher URL | http://journals.sagepub.com/doi/10.1258/phleb.2011.011103 |
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