The effect of endovenous laser ablation on restless legs syndrome.
OBJECTIVE
Venous disease was proposed as a cause of restless legs syndrome (RLS) by Dr Karl A Ekbom in 1944, but has since remained largely unexplored. This study examines the effect of endovenous laser ablation (ELA) in patients with concurrent RLS and duplex-proven superficial venous insufficiency (SVI).


METHODS
Thirty-five patients with moderate to very severe RLS (as defined by the 2003 National Institute of Health (NIH) RLS criteria) and duplex-proven SVI completed an international RLS rating scale questionnaire (IRLS) and underwent standard duplex examination to objectively measure the baseline severity of their conditions. They were separated into non-operative and operative cohorts. The operative cohort underwent ELA of refluxing superficial axial veins using the CoolTouch CTEV 1320 nm laser and ultrasound-guided sclerotherapy of the associated varicose veins with foamed sodium tetradecyl sulphate (STS). All patients then completed a follow-up IRLS questionnaire. Baseline and follow-up IRLS scores were compared.


RESULTS
Operative correction of the SVI decreased the mean IRLS score by 21.4 points from 26.9 to 5.5, corresponding to an average of 80% improvement in symptoms. A total of 89% of patients enjoyed a decrease in their score of > or =15 points. Fifty-three percent of patients had a follow-up score of < or =5, indicating their symptoms had been largely alleviated and 31% had a follow-up score of zero, indicating a complete relief of RLS symptoms.


CONCLUSIONS
ELA of refluxing axial veins with the CTEV 1320 nm laser and foamed STS sclerotherapy of associated varicosities alleviates RLS symptoms in patients with SVI and moderate to very severe RLS.


CONCLUSIONS
SVI should be ruled-out in all patients with RLS before initiation or continuation of drug therapy.
Hayes
C A
CA
Vein Center of North Texas, Denison, Texas, USA. chayesmd@gmail.com
Kingsley
J R
JR
Hamby
K R
KR
Carlow
J
J
D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D012148:Restless Legs Syndrome / Q000150:complications / Q000601:surgery* / Q000628:therapy; D012597:Sclerosing Solutions; D015911:Sclerotherapy; D012720:Severity of Illness Index; D012981:Sodium Tetradecyl Sulfate; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014648:Varicose Veins / Q000150:complications / Q000601:surgery* / Q000628:therapy; D014689:Venous Insufficiency / Q000150:complications / Q000601:surgery* / Q000628:therapy
D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate