Comparative Study between Conventional Surgery, Endovenous Laser Ablation and Saphenofemoral Disconnection with Endovenous Chemical Ablation for Treatment of Lower Limbs Varicose Veins

Abstract

Background: Chronic venous disease is the most common disorders of the peripheral vascular system. Endovenous , open surgery or hybrid ttt for varicose veins is commonly performed for treatment of primary VV. Objective: To evaluate safety and efficacy of triple saphenectomy, Endovenous laser ablation (EVLA) and Endovenous Chemical Ablation with Trendlenburge operation (eCAT) in comparative study as a methods of treatment of VV. Materials and Methods: 75 patients who had primary VV were included. They randomized into three equal groups each one was 25 patients group1 treated by triple saphenectomy , group 2 treated by EVLA,and group 3 treated by eCAT. 43 patients (57.3%) suffered from Disfigurment , 21 patients (28.0%) suffered from ulcer and 11 (14.7%) suffered from pain. With exclusion of patients with Infected ulcer, chronic deep venous thrombosis, incompetent deep venous system , recent pulmonary embolism. Results: For 75 patients over a period of 2 year of clinical and duplex follow up, 47 patients (62.7%) were done to them operation under spinal anesthesia, 5 (6.6%) under general and 23 (30.7%) under local A. Post-operative pain score decreased in patient treated with laser (group II) (3.15±0.73) and with e CAT (group III) (3.52±0.51) when compared with surgery (group I) (5.88±0.79) with statistical significant differences. Conclusion: Ablations may replace saphenous vein stripping and phlebectomy which as a single procedure without Trendlenberg’s operation may increase the risk of recurrence especially in yong age.eCAT is 1 operation with very low reccurence and it can improve all drawbacks of Convensional Surgery .