Endovenous laser ablation of incompetent great saphenous veins with 1470-nm laser using bare tip and radial fibers results in similar short-term outcomes

Abstract

ObjectiveThe common side effects of endovenous laser ablation (EVLA) are pain and discomfort in the treated leg. We compared the pain and outcomes after EVLA using a 1470-nm laser with bare tip or radial fibers in the treatment of incompetent great saphenous veins (GSVs). MethodsA total of 86 patients with primary varicose veins of the GSV were randomized to treatment using a 1470-nm laser and bare fiber (BF; n = 43) or radial fiber (RF; n = 43) during a 12-month period from January to December 2019. Patients were assessed clinically and using venous Doppler ultrasonography at 24 hours, 1 week, and 1 month. The periprocedural parameters and short-term outcomes of pain after the procedure, improvement in the Venous Clinical Severity Score (VCSS), and vein occlusion at 1 month were compared and analyzed. ResultsThe linear endovenous energy density (65.7 J/cm vs 65.2 J/cm), tumescent local anesthetic solution used (627.4 mL vs 661.4 mL), treated GSV length, and number of hook phlebectomies were similar in both groups. The pain score at 8 hours (2.77 vs 2.70) and 1 week (2.81 vs 2.74) were similar in the BF and RF groups, respectively. The improvement in the VCSS was significant in both groups and was slightly better in the BF group, although the difference was not statistically significant. Both fiber types had 100% efficacy in terms of closure of the treated vein at 1 month. ConclusionsEVLA using a 1470-nm laser with a BF had similar outcomes in the short term compared with a RF of the same wavelength. Both fibers were associated with significant improvement in the VCSS at 1 month.