Five-Year Results of a Randomized Controlled Trial Comparing High Ligation Combined With Endovenous Laser Ablation and Stripping of the Great Saphenous Vein

Abstract

Varicose vein surgery is followed by favorable clinical results and high patient satisfaction, with no difference between HL + S and HL + EVLA.

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.…”

“…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 .…”

“…Interestingly, two RCTs that compared combined high ligation and laser treatment with high ligation and stripping alone had similar 5‐year outcomes, practically eliminating the problem of stumps and incompetent AASVs. Further evidence that remaining stumps (SFJs) lead to an increasing problem over time exists in patients treated by radiofrequency ablation.…”

Aktuelle Therapieoptionen der Varikose der unteren Extremität

“…Auch wenn die EVLT mit einer Krossektomie kombiniert wird, sind die Ergebnisse nach 5 Jahren denen von Krossektomie und Stripping vergleichbar [29].…”