Comparison of Endovenous Treatment with an 810 nm Laser versus Conventional Stripping of the Great Saphenous Vein in Patients with Primary Varicose Veins

Medeiros, Charles Angotti Furtado de; Luccas, George Carchedi

doi:10.2310/6350.2005.31309

Cited by 67 publications

(37 citation statements)

References 54 publications

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“…15 The safety of EVLT and its efficacy in the early postoperative phase seem to be comparable with those of conventional surgery, as shown by recent randomized controlled trials (RCTs). [16][17][18][19][20][21] Although the procedure is considered to be highly variable in terms of wavelength, mode of application, power, and energy dose, EVLT is deemed to be safer and more effective compared with radiofrequency obliteration and ultrasonography-guided foam sclerotherapy. 14,22 However, there is still a medical need for further RCTs comparing endovenous techniques with standard surgical treatment of saphenous vein incompetence to drive reliable conclusions, particularly concerning clinical efficacy.…”

mentioning

confidence: 99%

Comparable Effectiveness of Endovenous Laser Ablation and High Ligation With Stripping of the Great Saphenous Vein

Rass

Frings²,

Glowacki³

et al. 2012

Arch Dermatol

126

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Objective: To compare the clinical efficacy and safety of endovenous laser treatment (EVLT) with high ligation and stripping (HLS) as standard treatment for great saphenous vein (GSV) insufficiency. Design: Two-center randomized controlled trial with 2-year follow-up. Setting: Interventions were performed on ambulatory and hospitalized patients at 2 vein centers, a university dermatology department (EVLT-treated group), and a specialized vein clinic (HLS-treated group). Patients: Random sample of 400 patients with GSV insufficiency. Interventions: Patients were assigned (1:1) to EVLT or HLS of the GSV from September 2004 through March 2007; 185 and 161 patients (limbs), respectively, were treated per protocol. Main Outcome Measures: Clinically recurrent varicose veins after surgery (REVAS classification, primary study objective), duplex-detected saphenofemoral recurrence, clinical venous severity scoring (Homburg Varicose Vein Severity Score), hemodynamics (venous refilling time), quality of life (Chronic Venous Insufficiency Questionnaire 2), adverse effects, and visual analog scalebased evaluations of patients' satisfaction. Results: Clinically recurrent varicose veins after surgery were similarly observed in both groups: 16.2% (EVLTtreated group) vs 23.1% (HLS-treated group); P=.15. Duplex-detected saphenofemoral refluxes occurred significantly more frequently after EVLT (17.8% vs 1.3%; PϽ.001). Both treatments equally improved medical condition (Homburg Varicose Vein Severity Score) and diseaserelated quality of life. Endovenous laser treatment caused more adverse effects (phlebitic reaction, tightness, dyspigmentation) but revealed advantages concerning hemodynamics, recovery, and cosmetic outcome. Conclusions: Both EVLT and HLS are comparably safe and effective procedures to treat GSV incompetence. The significantly higher rate and the course of duplexdetected saphenofemoral recurrences after EVLT remain a matter of further investigations.

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mentioning

confidence: 99%

Comparable Effectiveness of Endovenous Laser Ablation and High Ligation With Stripping of the Great Saphenous Vein

Rass

Frings²,

Glowacki³

et al. 2012

Arch Dermatol

126

View full text Add to dashboard Cite

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“…No difference in safety including the risk of venous thromboembolism could be determined, comparing EVTA and surgical treatment for saphenous vein incompetence. 367,391 The reported incidence of DVT varies between 0.2% and 1.3% in EVTA, and seems to be higher in patients treated with RFA compared with EVLA. 357 The latter meta-analysis mainly included the old RFA techniques and EVLA with bare tip fibres and lower wavelength.…”

Section: Endovenous Thermal Ablationmentioning

confidence: 99%

“…356,365,369,374,377,378 Post EVTA as opposed to surgery, swelling and bruising is reduced. 391 This results in quicker recovery 357,362,375,376 and faster return to normal activities. 364,365,374,378,392 Endovenously treated patients also seem to have an equal 364,366,367 or better 361 QoL after treatment.…”

Section: Endovenous Thermal Ablationmentioning

confidence: 99%

Editor's Choice – Management of Chronic Venous Disease

Davies

2015

European Journal of Vascular and Endovascular Surgery

688

218

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“…Comparative studies in which the outcomes of patients undergoing classic vein stripping (CVS) and EVLA were analyzed revealed that the latter experienced lower postoperative pain and bleeding, decreased frequency of wound infections and hematoma, and shorter time of convalescence [6, 7]. Literature is, however, not fully consistent in this regard, as there are also reports in which some postintervention effects of both kinds of surgery (e.g., pain, thrombosis, and bleeding) were comparable [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Endovenous Laser Ablation of Varicose Veins Preserves Biological Properties of Vascular Endothelium and Modulates Proinflammatory Agent Profile More Favorably Than Classic Vein Stripping

Uruski

Aniukiewicz

Mikuła-Pietrasik

et al. 2017

BioMed Research International

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Here we compared effect of serum from varicose patients undergoing endovenous laser ablation (EVLA) and classic vein stripping (CVS) on biological properties of endothelial cells and on the local and systemic profiles of proinflammatory agents. Results showed that serum from EVLA patients improved proliferation and reduced senescence and oxidative stress in the endothelial cells, as compared with the serum from CVS patients. These effects were related to a suppressed activity of TGF-β1, the level of which in the serum from the EVLA patients was decreased. Medium generated by the cells subjected to EVLA serum contained decreased amounts of ICAM-1, VCAM-1, and E-selectin and increased amount of uPA, whereas the serum itself contained decreased concentrations of ICAM-1, E-selectin, and P-selectin and increased concentrations of uPA, PAI-1, and TFPI. Both EVLA and CVS resulted in diversified patients' reaction with respect to a direction of postprocedure changes in proinflammatory factors' serum level. Analysis of proportions showed that the groups differed remarkably in case of ICAM-1 and ET-1, the level of which declined in a higher fraction of patients treated endovenously. Our findings indicate that EVLA preserves better than CVS the functionality of vascular endothelium and modulates better both local and systemic profile of proinflammatory mediators.

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Comparison of Endovenous Treatment with an 810 nm Laser versus Conventional Stripping of the Great Saphenous Vein in Patients with Primary Varicose Veins

Abstract: The endovenous great saphenous vein photocoagulation is safe and well tolerated and presents results comparable to those of conventional stripping.

Cited by 67 publications

References 54 publications

Comparable Effectiveness of Endovenous Laser Ablation and High Ligation With Stripping of the Great Saphenous Vein

Comparable Effectiveness of Endovenous Laser Ablation and High Ligation With Stripping of the Great Saphenous Vein

Editor's Choice – Management of Chronic Venous Disease

Endovenous Laser Ablation of Varicose Veins Preserves Biological Properties of Vascular Endothelium and Modulates Proinflammatory Agent Profile More Favorably Than Classic Vein Stripping

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