Effect of Endovenous Laser Ablation Along With Compression Therapy on Chronic Venous Ulcer Healing.

Abstract

Introduction Chronic venous insufficiency is a major cause of morbidity, and there is a paucity of data regarding its epidemiology due to the lack of a central wound registry. In this study, we aimed to study the time for healing of the ulcer and compliance with compression therapy (CT) following endovenous laser ablation (EVLA) ± ultrasound-guided foam sclerotherapy (UGFS) along with CT in patients with chronic venous ulcers. Methods This prospective observational study was conducted from January 2020 to June 2021 after obtaining institutional ethical committee clearance. Patients with chronic venous ulcers (>six weeks to <six months duration) were included in this study. Demographic details, venous duplex findings, and duration of ulceration were noted. All patients underwent EVLA (Biolitec® 1470 nm) ± UGFS and CT. The patients were followed up weekly till the healing of the ulcer, followed up at one month, three months, and then at six monthly intervals to look for recurrence. Venous clinical severity score (VCSS) at presentation and follow-up, compliance with CT, rate of ulcer healing at six months, and recurrence rates at two years of follow-up were observed prospectively. Results The mean age of the study participants was 45.7±14.2 years, of which 42 (84%) were males. Ulcer size of <2 cm was present in 38%, 2-4 cmin 52%, and >4 cmin 10% of patients. A total of 38% of patients underwent only EVLA, and EVLA+UGFS were done in 62% of participants. The healing rate at six months follow-up was 92%, with the average time taken being 2.55±1.38 months. Those who remained with an unhealed ulcer at six months follow-up had anulcer size of >5 cmand an age of >50 years. Ninety-six percent of the patients were compliant with CT after an endovenous intervention. The recurrence rate at two years post-ablation was 6%. VCSS was 19.66±3.23 at presentation and 5.5±2.82 at six months of follow-up. Conclusion Endovenous ablation of superficial venous reflux along with CT is associated with a shorter healing time of venous ulcerations and reduced chances of recurrence.There is an improvement in VCSS score over the period of six months follow-up.