Endovenous laser ablation with and without high ligation compared with high ligation and stripping in the treatment of great saphenous varicose veins: initial results of a multicentre randomized controlled trial

Flessenkämper, I.; Hartmann, Marius; Stenger, D.; Roll, Stephanie

doi:10.1258/phleb.2011.011147

Cited by 64 publications

(54 citation statements)

References 19 publications

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“…2,5,6,[8][9][10]12,32 The nature and frequency of complications were also similar to those previously reported in the literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The three groups had similar improvements in the venous clinical severity score at 6 months. However, successful ablation of the great saphenous veins at 6 weeks occurred significantly less often after foam treatment (complete ablation, 55%; partial ablation with a patent segment and no reflux, 23%) than after either surgery (complete ablation, 84%; partial ablation, 6%) or laser treatment (complete ablation, 83%; partial ablation, 8%).…”

Section: Discussionmentioning

confidence: 99%

“…Previous randomized trials and meta-analyses have shown these treatments to be effective in terms of short-term technical success and clinician-reported outcomes. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Clinical practice guidelines recommend the use of patient-reported quality of life to assess the outcomes of treatment of varicose veins. 20 Quality of life was a primary outcome measure in two small randomized trials that compared surgery and endovenous laser ablation, 5,9 but to our knowledge, it has not been assessed as a primary outcome in randomized trials involving foam sclerotherapy.…”

mentioning

confidence: 99%

See 1 more Smart Citation

A Randomized Trial Comparing Treatments for Varicose Veins

Brittenden¹,

Cotton²,

Elders³

et al. 2014

N Engl J Med

179

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A Randomized Trial Comparing Treatments for Varicose Veins

Brittenden¹,

Cotton²,

Elders³

et al. 2014

N Engl J Med

179

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“…Table 2 shows randomized clinical trials (RCTs) of EVLA with a 980 nm diode laser (EV) versus stripping (ST) in the literature. [18][19][20][21][22] The follow-up period was 1-5 years, and the recanalization rate of the treated saphenous vein was 4.3%-17.9% in the EV group and 0%-10.1% in the ST group, showing no significant difference between the two groups in each trial. [18][19][20]22) In our study, the recanalization rate 1 year after the operation was 2% in the EV group, being favorable similarly to the previously reported rates.…”

Section: Resultsmentioning

confidence: 98%

“…The varicose vein recurrence rate was 9%-46.6% in the EV group and 10%-54.6% in the ST group, showing no significant difference between the two groups. 18,21,22) The CEAP classification as a parameter of the clinical severity, VCSS, Aberdeen Varicose Vein Symptoms Severity Score (AVVSS), and the Short Form-36 score as a parameter of the QOL significantly improved after the operation in both the EV and ST groups, showing no significant difference between the two groups. 18,[20][21][22] In our study, the recanalization rate was similar between the EV and ST groups.…”

Section: Resultsmentioning

confidence: 99%

“…18,21,22) The CEAP classification as a parameter of the clinical severity, VCSS, Aberdeen Varicose Vein Symptoms Severity Score (AVVSS), and the Short Form-36 score as a parameter of the QOL significantly improved after the operation in both the EV and ST groups, showing no significant difference between the two groups. 18,[20][21][22] In our study, the recanalization rate was similar between the EV and ST groups. Although the QOL was not evaluated in the recanalization cases, there was no aggravation of symptoms, varicose vein recurrence, or venous function, which suggested that follow-up observation is possible even in recanalization cases.…”

Section: Resultsmentioning

confidence: 99%

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Positioning for Endovenous Laser Ablation: Comparative Study with Thigh Stripping

Tabuchi

Hara

Yunoki

et al. 2016

Annals of Vascular Diseases

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We performed a comparative study of surgical outcomes and venous functions between endovenous laser ablation with a 980-nm diode laser (EV group) and thigh stripping (ST group). There were no severe complications and initial success rates were 100% in both groups. In the EV group, preoperative symptoms improved in 94.3% of cases, the venous occlusion rate was 98%, and endovenous heat induced thrombosis had occurred in 11.9% (Class 3: 0.7%) at 12 months after the operation. Although comparative study of postoperative venous function by air plethysmography showed significant improvement in both groups, there was less recovery of postoperative venous function in the EV than in the ST group. (This article is a translation of J Jpn Coll Angiol 2015; 55: 13-20.) Keywords: endovenous laser ablation, 980-nm diode laser, stripping, primary varicose vein of saphenous trunk, air plethysmography the recurrence rate due to reflux are high, and previous studies comparing high ligation and stripping have shown a higher recurrence rate after the former.

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Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices

Nesbitt

Bedenis

Bhattacharya³

et al. 2011

Cochrane Database of Systematic Reviews

100

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BACKGROUND: Minimally invasive techniques to treat great saphenous varicose veins include ultrasound-guided foam sclerotherapy (USGFS), radiofrequency ablation (RFA) and endovenous laser therapy (EVLT). Compared with conventional surgery (high ligation and stripping (HL/S)), proposed benefits include fewer complications, quicker return to work, improved quality of life (QoL) scores, reduced need for general anaesthesia and equivalent recurrence rates. OBJECTIVE: To review available randomized controlled clinical trials (RCT) data comparing USGFS, RFA, EVLT to HL/S for the treatment of great saphenous varicose veins. METHODS: Search methods: The Cochrane Peripheral Vascular Diseases (PVD) Group searched their Specialized Register (July 2010) and CENTRAL (The Cochrane Library 2010, Issue 3). In addition the authors performed a search of EMBASE (July 2010). Manufacturers of EVLT, RFA and sclerosant equipment were contacted for trial data. Selection criteria: All RCTs of EVLT, RFA, USGFS and HL/S were considered for inclusion. Primary outcomes were recurrent varicosities, recanalization, neovascularization, technical procedure failure or need for reintervention, patient quality of life (QoL) scores and associated complications. Secondary outcomes were type of anaesthetic, procedure duration, hospital stay and cost. Data collection and analysis: CN, RE, VB, PC, HB and GS independently reviewed, assessed and selected trials which met the inclusion criteria. CN and RE extracted data. The Cochrane Collaboration's tool for assessing risk of bias was used. CN contacted trial authors to clarify details. MAIN RESULTS: Thirteen reports from five studies with a combined total of 450 patients were included. Rates of recanalization were higher following EVLT compared with HL/S, both early (within four months) (5/149 versus 0/100; odds ratio (OR) 3.83, 95% confidence interval (CI) 0.45 to 32.64) and late recanalization (after four months) (9/118 versus 1/80; OR 2.97; 95% CI 0.52 to 16.98), although these results were not statistically significant. Technical failure rates favoured EVLT over HL/S (1/149 versus 6/100; OR 0.12, 95% CI 0.02 to 0.75). Recurrence following RFA showed no difference when compared with surgery. Recanalization within four months was observed more frequently following RFA compared with HL/S although not statistically significant (4/105 versus 0/88; OR 7.86, 95% CI 0.41 to 151.28); after four months no difference was observed. Neovascularization was observed more frequently following HL/S compared with RFA, but again this was not statistically significant (3/42 versus 8/51; OR 0.39, 95% CI 0.09 to 1.63). Technical failure was observed less frequently follow

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Endovenous laser ablation with and without high ligation compared with high ligation and stripping in the treatment of great saphenous varicose veins: initial results of a multicentre randomized controlled trial

Cited by 64 publications

References 19 publications

A Randomized Trial Comparing Treatments for Varicose Veins

A Randomized Trial Comparing Treatments for Varicose Veins

Positioning for Endovenous Laser Ablation: Comparative Study with Thigh Stripping

Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices

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