Endoluminale Therapie – Lasertherapie und Radiofrequenzobliteration im 10-Jahresvergleich

Zusammenfassung

Hintergrund

In den letzten Jahren haben die unterschiedlichen endovenösen Operationen zur Behandlung der Beinvarikose an Bedeutung zugenommen. Ziel dieser 10-Jahres-Nachuntersuchung ist es, die Progression der Varikose bei Patienten zu beschreiben, die mit verschiedenen endovenösen Therapieverfahren (Radiofrequenzobliteration, Endoluminale Lasertherapie 980 nm bzw. 1470 nm) behandelt worden sind.

Methodik

Es wurden 371 Eingriffe in dieser nichtrandomisierten retrospektiven Single-Center-Studie eingeschlossen. Es erfolgte die klinische und duplexsonografische Untersuchung des behandelten Beines sowie ein Assessment mittels Fragebogen.

Ergebnisse

Bei der 10-Jahres-Nachuntersuchung wurden bei 65,7% der 268 untersuchten Patienten ein duplexsonografischer Reflux nachgewiesen. Die ermittelte Progressionsrate, Summe aus klinischen und duplexsonografisch nachgewiesenen Varizen, beträgt 43,5% (RFO VNUS Closure Fast 42,5%, ELVeS 980 43,5%, ELVeS 1470 44,7%). Bei der differenzierten Betrachtung der Rezidivbefunde konnte eine Progressionsrate von 28,4% ermittelt werden (RFO 27,5%, ELVeS 980 29,4%, ELVeS 1470 28,2%). Die Progressionsrate unabhängig von der behandelten Region war 15,3% (RFO 15,0 %, ELVeS 980 14,1%, ELVeS 1470 16,5%). Die gemittelte jährliche Progression der Varikose von Patienten, die mittels endovenöser Verfahren therapiert wurden, betrug 4,5%.

Schlussfolgerung

Die drei Verfahren unterscheiden sich nicht signifikant hinsichtlich der klinischen Kriterien und der duplexsonografischen Betrachtung nach 10 Jahren. Die ermittelte jährliche Progression von 4,5% nach endoluminaler Operation entspricht der zu erwartenden Progredienz innerhalb der Normalbevölkerung.

Abstract

Purpose

In recent years, the various endovenous operations for the treatment of leg varicosis have become increasingly important. The aim of this 10-year follow-up study is to describe the progression of varicose veins in patients who have been treated with various endovenous therapy procedures (radiofrequency obliteration, endoluminal laser therapy 980 nm or 1470 nm).

Methods

371 interventions were included in this non-randomized retrospective single-center study. Clinical and duplex sonographic examination of the treated leg and an assessment using a questionnaire were performed.

Results

At the 10-year follow-up, duplex sonographic reflux was detected in 65.7 % of the 268 patients examined. The determined progression rate, sum of clinical and duplex sonographically detected varices, was 43.5 % (RFO VNUS Closure Fast 42.5 %, ELVeS 980 43.5 %, ELVeS 1470 44.7 %). A differentiated analysis of the recurrence findings revealed a progression rate of 28.4 % (RFO 27.5 %, ELVeS 980 29.4 %, ELVeS 1470 28.2 %). The progression rate independent of the treated region was 15.3 % (RFO 15.0 %, ELVeS 980 14.1 %, ELVeS 1470 16.5 %). The annual progression of varicose veins in patients treated with endovenous procedures was 4.5 %.

Conclusion

The three procedures do not differ significantly with regard to clinical criteria and duplex sonographic observation after 10 years. The determined annual progression of 4.5% after endoluminal surgery corresponds to the expected progression within the normal population.

Schlüsselwörter

Vena saphena magna - Varicose - Rezidiv

Keywords

great saphenous vein (GSV) - varicose veins - recurrence

Publication History

Received: 15 April 2025

Accepted after revision: 27 August 2025

Article published online:
14 October 2025

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