Endovenous laser therapy vs. high ligation/stripping for varicosity of the great saphenous vein.

Summary

Introduction: Varicosis therapy options include a combination of crossectomy/stripping and the endoluminal laser therapy, however, to date lacking statistically relevant data.

Material and Methods: In an open multi-centre, randomized 3-arm-trial sonographic and clinical parameters were compared perioperatively, and after 2 and 6 months between endoluminal venous laser therapy, high ligation, and invaginating stripping. (Laser: 980 nm Biolitec^©, Continous-Mode, 30 W). Data of 449 patients were available for the perioperative and 2 months examination. 388 patients were followed up until 6 months. We compare clinical recurrencies, sonographic reflux findings, and refluxive side branches in the inguinal region at the saphenofemoral junction.

Results: We found significantly more refluxive side-branches in the laser groups, however, no statistically significant relation between clinical recurrencies and sonographic reflux. Over the time, there were no intraindividual constant refluxes. Regarding the further endpoints edema, lymphatic edema, local disturbancies of sensibility and irritations of the saphenous nerve, matting and postoperative restricitions, lymphatic edema, local disturbancies of sensibility and irritations of the saphenous nerve were significantly more present in the two laser groups.

Discussion: In a long time follow-up we have to investigate the importance of refluxive side-branches for the development of clinical recurrencies. According to the findings on side effects, the tested laser technique is not less harmful to the patients than open surgery.

Keywords

EVLT - crossectomy - rct - side effects - ultrasound

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