Early and Mid-Term Results of Treatment of Superficial Venous Insufficiency of the Lower Extremity Using Endovenous Laser Therapy

Abstract

Background and aim of the study: Endovenous laser ablation (ELA) has become an important procedure to treat saphenous vein reflux. In this study the early and mid-term results of endovenous laser ablation of the long or/and short saphenous veins (ELAS) will be evaluated. Patients and methods: This prospective study was conducted from March 2010 to December 2016. The study enrolled 35 symptomatic patients with unilateral or bilateral superficial venous insufficiency (CEAP; 2-6) with documented reflux in long saphenous, short saphenous, or both veins by duplex ultrasound. Results: Thirty five patients were enrolled in this study, 30 women with mean age 35.5± 8.2 years and 5 men with mean age of 32.2± 7.8 years. ELAS was performed in 52 limbs 9 of them had ulcers. Early postoperative clinical and ultrasound examination revealed complete ablation of the targeted veins (100%) with no reflux. Great saphenous alone was ablated in 76.9% of limbs, short saphenous in 13.5%, and both 9.6%. Postoperative complications were minimal, well tolerated, and completely resolved within 3-27weeks with treatment. In 88.9% of limbs with active ulceration, healing occurred after a mean of 6.6±1.6 months. Only 61.5% of legs (including all ulcer patients) were followed up for 49.5±11.3 months; recorded recanalization by duplex ultra sound was 0%, 10.3%, and 20.8% after 1, 3, and 5 years respectively. Recanalization was insignificantly higher in long than short saphenous veins. The recorded recurrence of ulcers after 1, 3, and 5 years of follow up was 0%, 12.5%, and 40% respectively. Conclusion: endovenous laser ablation of the saphenous veins is safe and has excellent early and mid-term outcomes for treatment of superficial venous insufficiency with or without ulceration of the lower extremities.