title: Endovenous laser ablation in the treatment of small saphenous varicose veins: does site of access influence early outcomes?
abstract: OBJECTIVE
  The study was performed to evaluate the clinical and technical efficacy of endovenous laser ablation (EVLA) of small saphenous varicosities, particularly in relation to the site of endovenous access.
  
  
  METHODS
  Totally 59 patients with unilateral saphenopopliteal junction incompetence and small saphenous vein reflux underwent EVLA (810 nm, 14 W diode laser) with ambulatory phlebectomies. Small saphenous vein access was gained at the lowest site of truncal reflux. Patients were divided into 2 groups: access gained above mid-calf (AMC, n = 33) and below mid-calf (BMC, n = 26) levels. Outcomes included Venous Clinical Severity Scores (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ), patient satisfaction, complications, and recurrence rates.
  
  
  RESULTS
  Both groups demonstrated significant improvement in VCSS, AVVQ, generic quality of life Short Form 36, and EuroQol scores (P < .05) up to 1 year. No differences were seen between AMC and BMC groups for complications (phlebitis: 2 [6%] and 1 [3.8%], P > .05; paresthesia: 2 [6%] and 5 [19%], P = .223) and recurrence (3 [9%] and 1 [3.8%], P = .623), respectively.
  
  
  CONCLUSIONS
  The site of access in our study does not appear to influence complications specifically neural injury or recurrence rates.
authors.affiliation: Academic Vascular Surgical Unit, Hull York Medical School, University of Hull, UK. nehemiah.samuel@hey.nhs.uk
authors.forename: Nehemiah
authors.initials: N
authors.lastname: Samuel
authors.forename: T
authors.initials: T
authors.lastname: Wallace
authors.forename: D
authors.initials: D
authors.lastname: Carradice
authors.forename: Y
authors.initials: Y
authors.lastname: Shahin
authors.forename: F A K
authors.initials: FA
authors.lastname: Mazari
authors.forename: I C
authors.initials: IC
authors.lastname: Chetter
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D004739:England; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation; D054023:Lasers, Semiconductor; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology; D017060:Patient Satisfaction; D059348:Peripheral Nerve Injuries / Q000209:etiology; D010689:Phlebitis / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012501:Saphenous Vein / Q000601:surgery*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014648:Varicose Veins / Q000175:diagnosis / Q000601:surgery*