Randomized clinical trial comparing two methods for endovenous laser ablation of incompetent perforator veins in thigh and great saphenous vein without evidence of saphenofemoral reflux.
BACKGROUND
Percutaneous ablation of incompetent perforators has been introduced as a safe and efficacious alternative.


OBJECTIVE
To compare two methods of treating incompetent thigh perforator and great saphenous veins (GSV).


METHODS
Patients with varicose veins of CEAP C2 and C3 with incompetent perforating veins (IPVs) in the thigh without evidence of saphenofemoral reflux and with obvious venous reflux from IPVs into the GSV distal to IPVs were included. Endovenous laser ablation was done using two methods (IPV ablation (IPVA) versus GSV ablation: GSVA). Their technical success rate, clinical success rate, and complications were compared at 1 week, and 1, 3, 6, and 12 months.


RESULTS
Sixty-nine consecutive patients were randomized to IPVA (n = 34) or GSVA (n = 35). Technical success was significantly lower with IPVA than GSVA (p = .002). Clinical success, defined as continued closure of treated veins, was similar with IPVA and GSVA (96.1% vs 100% at 1 week, 100% vs 97.1% at 1 month, and 100% for both at 3, 6, and 12 months, respectively).


CONCLUSIONS
IPVA has clinical results and complications similar to those of GSVA in individuals with C2 and C3 chronic venous disease with IPVs in the thigh combined with incompetent GSV, but its higher technical failure rate makes it difficult to choose it as the primary treatment method.
Departments of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea.
Sang Woo
SW
Park
Jae Joon
JJ
Hwang
Ik Jin
IJ
Yun
Song Am
SA
Lee
Jun Seok
JS
Kim
Seong-Hwan
SH
Chang
Hyun Keun
HK
Chee
Il Soo
IS
Chang
D000368:Aged; D057510:Endovascular Procedures / Q000379:methods*; D005240:Feasibility Studies; D005268:Femoral Vein; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D013848:Thigh / Q000098:blood supply*; D014648:Varicose Veins / Q000601:surgery*