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Endovenous laser ablation of saphenous vein – mid-term results confirm permanent closure and possibility to treat more lesions in one procedure

Czech version

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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Perspectives in Surgery

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2020 Issue 7
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