Microwave versus Endovenous LASER in Great Saphenous Vein Ablation of 340 Patients: Randomized Controlled Clinical Study

Purpose: The main objective of this research was to compare the efficacy, safety, and impact on quality of life of endovenous microwave ablation (EMA) and endovenous laser ablation (EVLA) for management of varicose veins of the greater saphenous vein (GSV).

Materials and Methods: Comparative, multicenter, single-blinded, parallel randomized controlled study conducted on 340 patients confirmed to have primary VVs of the GSV who were further randomized into two groups. The study group (n = 170) received EMA, and the control group (n = 170) received EVLA.

Results: Both the study group and the control group were comparable with regard their baseline characteristics (p-values > 0.05). Both the study group and the control group were comparable with regard limb affected (p = 0.184). Only 14.7% & 10.0% of both the study group and the control group have both limbs affected. Both the study group and the control group were comparable with regard CEAP-classification (p = 0. 068). Both the study group and the control group were significantly different with regard operating time (p < 0.001). The operating time is less in the study group than in the control group. The median (IQR) & the mean ± SD of the operating time was 7 (4) & 8.7 ± 4.1 minutes in the study (microwave) group; and 9 (5) & 10 ± 3.9 minutes in the control group. Also, the study group and the control group showed 100% success at 1-week evaluation as none of the cases in both groups suffered recanalization. At 6-month evaluation, only one case in the study group and two cases of the control group experiences recanalization; however, the difference is not significant (p = 0.537). At 12-month evaluation, the study group and the control group showed 100% success as none of the cases in both groups suffered recanalization. QoL is better in the study group than the control group at 6-months Aberdeen score (p ≤ 0.001). The median (IQR) & the mean ± SD of the postoperative Aberdeen score was 9 (2.7) & 9.3 ± 1.7 in the study (microwave) group; and 10.8 (3.4) & 10.8 ± 1.8 in the control group. Moreover, the study group and the control group were comparable (p-values > 0.05) with regard adverse events except for paresthesia (p-value = 0.025). About 11.2% of the control group experienced paresthesia versus only 2.9% of the study group.

Conclusion: EMA has lower operating time than EVLA. EMA is as effective as EVLA for treating VVS of the GSV. EMA has less adverse events than EVLA. EMA has better QoL than EVLA ablation. However, the choice of treatment should be based on individual patient characteristics and the expertise of the treating physician.

Publication History

Article published online:
02 April 2024