title: The role of cryosurgery in the treatment of the incompetent great saphenous vein.
abstract: Our aim was to determine the place of cryosurgery in the treatment of the incompetence of the great saphenous vein. Primary end-point of this study was to evaluate the clinical effectiveness of cryostripping and cryosclerosis. Complications frequently related to saphenous vein stripping were analyzed secondary. A literature search was conducted in the PubMed-database until September 2014. Randomized controlled trials with at least 6 months follow-up were eligible. Meta-analysis was performed by the IVhet-model. Forty-two unique publications were found- Five of them (3 trials), comparing cryostripping to stripping and endovenous LASER ablation, were eligible for meta-analysis. There were no significant differences between cryostripping and conventional stripping regarding the clinical effectiveness (P=0.06; RR:1.12; 95% of CI: 0.99-1.27) and saphenous neuralgia related to surgery (P=0.48; RR:0.94; 95% of CI: 0.89-0.99). The records of bruising were not uniform and comparable. No randomized controlled trials were found to perform a meta-analysis on cryosclerosis, therefore a short literature review is presented. The study has limitations and weak conclusions because of imprecision (small number of involved trials and limbs) and short term follow-up. Low quality evidences suggest that cryostripping is a reliable, efficient method with better cosmetic results than conventional stripping, however, long term comparisons are not available so far. Cryosclerosis could be an alternate to the known endovenous minimal invasive ablation procedures, but there are no exact strong evidences, especially on the long term.
authors: Faculty of Business and Economics, University of Pannonia, Nagykanizsa, Hungary - balint_istvan_bence@yahoo.com.
authors: Renata
authors: R
authors: Balint
authors: Laszlo
authors: L
authors: Vizsy
authors: Akos
authors: A
authors: Farics
authors: Istvan B
authors: IB
authors: Balint
mesh_terms: D003452:Cryosurgery; D006801:Humans; D012501:Saphenous Vein / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods; D014689:Venous Insufficiency / Q000601:surgery*