Abstract
Purpose To determine the effectiveness of endovenous laser ablation (EVLA) for non-great saphenous veins, and to compare to GSV EVLA outcomes. Materials and Methods IRB and HIPAA compliance were obtained. A retrospective review of electronic medical records of all patients with EVLA performed from July 2003 to March 2012, at a high volume outpatient interventional radiology office practice was performed. Data collected included age, sex, vein treated, and parameters of treatment - i.e. watts, length of vein treated, energy density (J/cm) and tumescent anesthesia volume. Follow-up ultrasound exam(s) and occlusion rates were obtained. Non- GSV veins were defined as small saphenous vein (SSV), accessory lateral tributary (ALT), and other (intersaphenous veins, perforators, non-named veins). Primary endpoint was primary occlusion rate (PO) of non-GSV ablations. PO was defined as US non-compressibility and lack of color Doppler flow in the vein segment treated with EVLA. Secondary endpoint was comparison of PO rates of non GSV veins segments with contemporaneously treated GSV. Fisher's exact and Pearson chi2 tests were performed. Results There were 504 non-GSV treated. The distribution of vein segments was 259 (51.4%) SSV, 141 (28.0%) ALT, and 104 (20.6%) other. The average US follow-up duration was 299.9 days (range 6 - 1863). The overall non GSV PO was 97.2% (490/504). PO for SSV, ALT, and other were 96.5% (250/259), 96.5% (136/141), and 100% (104/104) respectively. During the same time interval, 1301 GSV were treated with PO of 96.5% (1255/1301) with average US follow-up of 298.2 days (range 5 - 1983). The overall average age was 51.3 years (range 21-86) with sex distribution of 1458 (80.8%) women and 347 (19.2%) men. There was no statistically significant difference between non GSV and GSV in primary occlusion rates (p=0.42). There was also no statistically significant difference among SSV, ALT, other, and GSV in primary occlusion rates (p=0.207). Conclusion Non GSV (SSV, ALT, and other) EVLA has a high primary occlusion rate at long -term follow-up, with no difference compared to GSV EVLA. Results strongly support the clinically indicated treatment of non GSV with EVLA.
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