Endovenous laser treatment for varicose veins in patients with active ulcers: measurement of intravenous and perivenous temperatures during the procedure.
BACKGROUND
Conventional saphenous vein stripping is difficult to be indicated for the treatment of varicose veins in patients classified as CEAP C4, C5, or C6.


OBJECTIVE
This study was developed to evaluate treatment results for varicose veins with active ulcers using endovenous laser (EVL), compared to a group undergoing clinical treatment, during 1 year.


METHODS
Fifty-two patients presenting with varicose veins with active ulcers for more than 1 year were divided for treatment into two randomized groups: Group 1, clinical treatment, composed of 25 subjects, was submitted to elastic or inelastic compression therapy; Group 2, EVL treatment, composed of 27 subjects, was submitted to great and or small saphenous vein ablation with a 980-nm diode EVL, plus the clinical treatment. Intravenous and perivenous temperatures were measured continuously during the EVL treatment. All patients were followed for 12 months and studied with ultrasound at the beginning and end of the study. The ulcers' areas were evaluated initially and at every 3 months.


RESULTS
In 12 months, 81.5% of the wounds in patients in Group 2 and only 24% in patients in Group 1 had healed. Ulcer recurrence rate was 44.4% in Group 1. The mean wound area in Group 1 decreased from 17.48 to 12.76 cm(2) at the end of the year. In Group 2, the wound area decreased from 22.26 to 2.7 cm(2) (p=.0037). Mean intravenous and perivenous temperatures of 79.3 and 43.0 degrees C were recorded.


CONCLUSIONS
The treatment for varicose veins with EVL is safe in patients with active ulcers. Wounds healed faster than in patients undergoing clinical treatment alone during a 1-year period. There was no ulcer recurrence in patients treated with EVL.
Viarengo
Luiz Marcelo Aiello
LM
Department of Surgery, State University of Campinas, Campinas, São Paulo, Brazil.
Potério-Filho
João
J
Potério
Gloria Maria Braga
GM
Menezes
Fábio Hüsemann
FH
Meirelles
Guilherme Vieira
GV
D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D007871:Leg Ulcer / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000601:surgery*; D012720:Severity of Illness Index; D012881:Skin Temperature; D016896:Treatment Outcome; D014648:Varicose Veins / Q000150:complications / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing