Endovenous laser ablation of great saphenous vein with ultrasound-guided perivenous tumescence： early and midterm results

• Published in: Chinese medical journal Vol. 126; no. 3; pp. 421 - 425
• Main Authors: Chen, Jia-quan, Xie, Hui, Deng, Hao-yu, Yuan, Kai, Zhang, Ji-wei, Zhang, Hao, Zhang, Lan
• Format: Journal Article
• Language: English
• Published: China Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China 01-02-2013
• Subjects: Adult; Aged; Female; Humans; Laser Therapy - methods; Male; Middle Aged; Prospective Studies; Saphenous Vein - diagnostic imaging; Saphenous Vein - surgery; Treatment Outcome; Ultrasonography; Varicose Veins - diagnostic imaging; Varicose Veins - surgery; 中期; 住院治疗; 多普勒超声; 引导; 早期; 激光消融; 腔内; 静脉曲张; great saphenous vein; tumescent anaesthesia; endovenous laser ablation; occlusion
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.20122290

Background Endovenous laser ablation （EVLA） is an improved method to treat varicose great saphenous veins （GSV） with a high satisfactory rate. This study aimed to evaluate the efficiency and safety of treatment by EVLA procedures with ultrasound-guided perivenous tumescence. Methods Thirty-one patients （31 limbs） with symptomatic varicose vein primary to chronic venous insufficiency （CVI） treated with EVLA were prospectively studied. The entire procedure was performed under ultrasound-guided tumescent local anesthesia. The patients were evaluated with a 18 month follow-up postoperation using clinical examination and venous duplex ultrasonography. Pain scores and quality of life （QOL） were recorded using visual analog scale （VAS） and the chronic venous insufficiency questionnaire （CIVIQ） at 1 week, 1 month, and 12 months after operation. Results All patients tolerated EVLA procedure well. The overall success occlusion rates of GSV were 92%, 94%, and 94% at 1, 12, and 18 months follow-up, respectively. The score of CIVIQ one week preoperation was 69.14±11.44 while that of CIVIQ one month postoperation was 85.32±4.89. The life quality has significantly improved after the operation of EVLA （t=12.71, P 〈0.05）. The VAS one month after treatment was lower than 1 week before therapy （t=8.048, P 〈0.05）. Major complications such as deep vein thrombosis and skin burns were not found. Most of the complications were minor and improved quickly. Conclusions This refinement type of EVLA procedure is a safe and effective treatment with a high satisfaction rate; it displayed noteworthy features including shortening hospitalization, early ambulant activity, and preferable occlusion rates.