Outcome of endovenous laser therapy for saphenous reflux and varicose veins: medium-term results assessed by ultrasound surveillance.
OBJECTIVE
To assess the efficacy of endovenous laser therapy (EVLT) for treating saphenous reflux associated with varicose veins.


METHODS
Out-patient treatment by EVLT with an 810nm laser wavelength with results assessed by ultrasound surveillance.


METHODS
361 patients who received EVLT for 509 incompetent saphenous veins over a five-year period.


METHODS
EVLT was used for proximal saphenous veins and ultrasound-guided sclerotherapy (UGS) for distal saphenous veins and tributaries. Control of reflux and occlusion or obliteration of the saphenous veins was assessed by serial ultrasound studies. Univariate Kaplan-Meier life table analysis showed cumulative primary and secondary success rates, and multivariate Cox regression analysis assessed covariates that could be associated with increased risk of ultrasound failure.


RESULTS
Life table analysis showed primary success at four years in 76% (95% CI 56-87%) and secondary success at four years after further treatment of recurrence by UGS in 97% (95% CI 93-99%). Cox regression analysis showed a non-significant trend towards worse primary success in male patients and worse results for older patients and limbs with clinical CEAP categories C4-6. Cox regression showed significantly worse secondary success for limbs with clinical CEAP C4-6.


CONCLUSIONS
EVLT effectively controls saphenous reflux particularly with ultrasound surveillance to detect early recurrence that can be treated by UGS. Modifications in technique may be required to improve the late primary success rate.
Myers
K A
KA
Epworth Hospital, 32 Erin Street, Richmond, Melbourne, Victoria 3121, Australia. kamyers@bigpond.net.au
Jolley
D
D
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000601:surgery*; D015911:Sclerotherapy; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014648:Varicose Veins / Q000000981:diagnostic imaging* / Q000601:surgery*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*; D055815:Young Adult