Endovenous Laser Ablation (Evla) Versus High Ligation and Striping (hl/S): Two-Years Follow Up

Abstract

Endovenous laser ablation (EVLA) of the great saphenous vein (GSV) is thought to minimize postoperative morbidity and reduce work loss compared with high ligation and stripping (HL/S). However, the procedures have not previously been compared in a trial with parallel groups where both treatments were performed in tumescent anesthesia on an out-patient basis. Patients with varicose veins due to GSV insufficiency were randomized to either EVLA (980 nm) or HL/S in tumescent anesthesia. Miniphlebectomies were also performed. In our clinics, 87 varicosis patients were treated between September 2006 and December 2009. EVLA was applied in 90 cases and HL/S was applied in 84 cases. Clinical features and demographic characteristics of the patients were summarized. EVLA procedure was done by 980 nm diode laser (Ceralas D 980, Biolitec) at continues mode with 15 W energy. Patient visits were done at post-operative 10th day, 6th month, 1st year and 2nd year. Routine physical examination and Doppler USG assessments were performed at these visits. EVLA and HL/S procedures were done in complete success in all cases at both groups. All cases were invited for control visits. At post-operative 10th day all patients were evaluated, at 1st year control visit number of attended patients was 130 (EVLA: 68, HL/S: 62) and at 2nd year control, visit number of attended patients was 104 (EVLA: 56, HL/S: 48). When complications developed after procedures were evaluated; no infection, hematoma or paresthesis were observed in EVLA group. However in HL/S group; infections, hematomas and paresthesis were observed in 2, 6 and 24 cases respectively. In terms of treatment success there was not significant difference between EVLA procedure and HL/S methods. However, in terms of post-op complication, EVLA method was associated with significantly less paresthesis, hematoma and pain. EVLA method is a method as effective and safe as standard treatment. However, when a long term result of this method is shown completely, its effectiveness will be cleared and its clinical utility will be established.