Invited commentary.

Abstract

The current manuscript provides clinical outcomes of 173 limbs with Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) clinical class 5 (C5) and class 6 (C6) disease treated with endovenous thermal ablation (EVTA). EVTA has replaced open surgical therapies for lower CEAP categories because of similar efficacy, local anesthesia, immediate return to activity, and satisfaction of the patients. Despite multiple trials comparing EVTA with open surgical treatment of the superficial system and perforators, there are concerns that clinical CEAP C5 and C6 may have marginal outcomes with EVTA. It is a reasonable concern that EVTA may not achieve the same results as demonstrated in the Effect of Surgery and Compression on Healing and Recurrence (ESCHAR) trial. Incidence of venous leg ulcer healing and recurrence after treatment with endovenous laser ablationJournal of Vascular Surgery: Venous and Lymphatic DisordersVol. 5Issue 4PreviewThe Effect of Surgery and Compression on Healing and Recurrence (ESCHAR) trial previously reported that patients with venous leg ulcers treated with saphenous stripping experienced a significantly reduced incidence of ulcer recurrence compared with patients treated with compression therapy. Most patients with leg ulcers and saphenous insufficiency are currently treated with endovenous thermal ablation (EVTA), but little information is available on the long-term results after EVTA in Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) clinical class 5 (C5) and class 6 (C6) patients. Full-Text PDF