Early clinical improvement in chronic venous insufficiency symptoms after laser ablation of saphenous veins

Abstract

We aimed to assess the degree of improvement in chronic venous disease-related symptoms after endovenous laser ablation (EVLA) for saphenous vein insufficiency. The study was conducted as a single-center, single-arm prospective cohort study. The series was comprised of 55 limbs of 38 patients (24 [63%] females, 14 [37%] males; mean age, 45 ± 14 years; range, 22-78 years). All patients were clinically evaluated for limb pain, fatigue, heaviness, itchiness, night cramps, burning sensation, swelling, varices, and the presence of venous ulcers. Post-procedure changes in each symptom were categorized as full recovery, improvement, no change, or worsened. Clinical improvement in one or more symptoms was observed in 96% of the limbs, and full recovery from each symptom ranged from 36% to 80%. The best clinical response was observed in night cramps, with full recovery in 80% of the limbs, while the least responsive was pain, with full recovery in 36%. Overall 25% of limbs showed full recovery from all symptoms. The venous clinical severity score was significantly decreased from a median of 5 (range, 1-21) before treatment to a median of 3 (range, 0-12) after treatment (P < 0.001). A significant association was found between full recovery from pain and older age (P = 0.016) and combined ablation of both saphenous veins (P = 0.010), and between full recovery from burning sensation and the presence of new incompetent perforator veins (P = 0.048) on multivariate analysis. EVLA effectively improves clinical symptoms in patients with chronic venous disease. The degree of symptomatic improvement varies for each symptom.