Literature DB >> 18278775

Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins.

R J Darwood1, N Theivacumar, D Dellagrammaticas, A I D Mavor, M J Gough.   

Abstract

BACKGROUND: Endovenous laser ablation (EVLA) is a minimally invasive technique for treating varicose veins due to truncal vein incompetence. This randomized trial compared EVLA with conventional surgery in patients with primary saphenofemoral and great saphenous vein (GSV) reflux.
METHODS: Consecutive consenting patients with symptomatic varicose veins were randomized to EVLA 1 (stepwise laser withdrawal), EVLA 2 (continuous laser withdrawal) or surgery (saphenofemoral ligation, GSV stripping, multiple phlebectomies). Principal outcome measures were abolition of GSV reflux and improvement in Aberdeen Varicose Vein Symptom Score (AVVSS) 3 months after treatment.
RESULTS: GSV reflux was abolished in 41 of 42 legs treated with EVLA 1, 26 of 29 following EVLA 2 and 28 of 32 after surgery (P = 0.227). The median (interquartile range, i.q.r.) AVVSS improvement was similar: 9.38 (4.54-14.93) with EVLA 1, 10.26 (5.03-15.03) after EVLA 2 and 8.36 (4.54-13.21) following surgery (P = 0.694). Return to normal activity (median (i.q.r.) 2 (0-7) versus 7 (2-26) days; P = 0.001) and work (4 (2-7) versus 17 (7.25-33.25) days; P = 0.005) was quicker after EVLA by either method.
CONCLUSION: Abolition of reflux and improvement in disease-specific quality of life was comparable following both EVLA and surgery. The earlier return to normal activity following EVLA may confer important socioeconomic advantages. REGISTRATION NUMBER: ISRCTN99270116 (http://www.controlled-trials.com). 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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Year:  2008        PMID: 18278775     DOI: 10.1002/bjs.6101

Source DB:  PubMed          Journal:  Br J Surg        ISSN: 0007-1323            Impact factor:   6.939


  32 in total

1.  Endoluminal thermal ablation versus stripping of the saphenous vein: Meta-analysis of recurrence of reflux.

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Review 4.  [Endovenous ablation versus open surgery for varicose veins : An attempt at an evaluation].

Authors:  K Hartmann; D Stenger; M Hartmann; L Rafi-Stenger
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5.  An update in varicose vein pathology after ten years of endovenous laser therapy (EVLT) with a 980 nm diode laser: clinical experience of a single center.

Authors:  Pietro Scarpelli; Annamaria Maggipinto; Marco Leopardi; Evelina Di Marco; Angelo Disabato; Michelangelo Boschetti; Giorgio Sbenaglia; Carlo Spartera; Marco Ventura
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6.  Study on the Long-Term Results of Endovenous Laser Ablation for Treating Varicose Veins.

Authors:  Seung Je Go; Byung Sun Cho; Yun Su Mun; Yoon Jung Kang; Hye Young Ahn
Journal:  Int J Angiol       Date:  2015-07-10

7.  Venous ulcers: new options in treatment: minimally invasive vein surgery.

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8.  Endovascular laser therapy for varicose veins: an evidence-based analysis.

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Journal:  Ont Health Technol Assess Ser       Date:  2010-04-01

9.  Comparison of 1470 nm Laser and Radial 2ring Fiber with 980 nm Laser and Bare-Tip Fiber in Endovenous Laser Ablation of Saphenous Varicose Veins: A Multicenter, Prospective, Randomized, Non-Blind Study.

Authors:  Masayuki Hirokawa; Tomohiro Ogawa; Hiromitsu Sugawara; Shintaro Shokoku; Shoji Sato
Journal:  Ann Vasc Dis       Date:  2015-09-09

10.  Efficacy of topical local anaesthesia to reduce perioperative pain for endovenous laser ablation of varicose veins: a double-blind randomized controlled trial.

Authors:  Sunita Saha; Alok Tiwari; Charlotte Hunns; Jonathan Refson; Ahmed Abidia
Journal:  Ther Adv Cardiovasc Dis       Date:  2016-04-19
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