Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia

Abstract

At the 5-year follow-up, a significantly higher varicose vein recurrence rate originated at the SFJ region after EVLA compared with SFL/S. There were no differences in the relief of venous symptoms, CEAP staging, or general QoL between the groups.

Eight-year follow-up of a randomized clinical trial comparing ultrasound-guided foam sclerotherapy with surgical stripping of the great saphenous vein

“…In comparison, the above‐knee GSV recurrence rate of reflux in the HL/S group was 17 per cent after 2 years, with a slight increase to 20·4 per cent by 8 years. The 2‐year results for HL/S differ from those reported by Rasmussen and colleagues, but are consistent with others. The 8‐year results for HL/S are comparable to long‐term results reported in other studies.…”

Reconsidering the endovenous revolution

“…These differences have implications for the need for retreatment. Longer‐term data from randomized clinical trials (RCTs) and cohort studies, after an average of 5 years of follow‐up, suggest that these differences seem to increase over time.…”

“…The AASV appears to play a major role. An incompetent SFJ where the incompetence is propagated down the AASV seems to be the most common scenario, often with clinical recurrence and symptoms. Many more patients, who are not yet symptomatic, can be added by duplex detection.…”

“…A recent review regarding recurrence following endovenous ablation included only a single 5‐year report, where around half of patients were lost to follow‐up. Since then five RCTs and two large cohort studies with long‐term results have been published. All have shown a similar pattern regarding groin recurrence, with stumps and incompetent AASVs as the major reasons for recurrence in patients having thermal ablation (around 30 per cent at 5 years).…”

“…To date, only endovenous laser ablation and foam sclerotherapy have been evaluated against high ligation and stripping in the long term. In one study foam treatment was associated with significantly more recurrence and need for retreatments compared with laser and surgery .…”