Page 24 - vascular professional 01_2021_eMagazine

vascular professional | issue 01 · 2021 abstract

Favorable long-term results of

endovenous laser ablation of great and

small saphenous vein incompetence
with a 1470-nm laser and radial fi ber

PATRIZIA PAVEI, M.D.; GIORGIO SPREAFICO, M.D.; ENRICO BERNARDI,
M.D., PH.D.; ENZO GIRALDI, M.D.; MAURIZIO FERRINI, M.D.

Abstract associations between the study outcomes and variables
by multiple logistic regression techniques.
Objective:
Scarce information is available on the long-term results Results:
of endovenous laser ablation (EVLA) for great saphenous Some 10 years after EVLA, we performed a single clinical
vein (GSV) or small saphenous vein (SSV) insuffi ciency. and ECD evaluation in 203 patients. Only one recanaliza-
We sought to provide data on the status of patients at tion (0.5%; 95% confi dence interval, 0.0-2.7) of the tre-
least 9 years after EVLA. ated GSV trunk was observed in an otherwise asympto-
abstracts Methods: matic patient. Up to 98% of patients were asymptomatic
or signifi cantly improved after EVLA. Additional subse-
In 2018, we undertook a cross-sectional survey of ambu-
quent treatments occurred in 21% of patients with GSV
latory patients who had undergone EVLA in our tertiary insuffi ciency and 5% of patients with SSV insuffi ciency.
care center in 2008-2009. Of 240 eligible patients, 5 died Three complications were observed, two in the GSV group
of causes not related to EVLA, 20 refused to participate, (varicophlebitis, saphenous nerve damage) and one (vari-
and 12 were lost to follow-up. Thus, 203 patients were re- cophlebitis) in the SSV group. The mean C class of CEAP
evaluated; of them, 161 (79%) had GSV insuffi ciency and and the mean VCSS were signifi cantly lower at the end of
42 (21%) had SSV insuffi ciency. The mean follow-up was follow-up, both in patients with GSV insuffi ciency (C class,
114 months (standard deviation, 11 months). All included 3.2 vs 1.5 [P = .00001]; VCSS, 6.3 vs 1.6 [P = .001]) and
patients underwent an echocardiography-color Doppler in patients with SSV insuffi ciency (C class, 2.9 vs 1.1 [P =
(ECD) evaluation, a clinical visit, and a standardized me- .00001]; VCSS, 5.4 vs 0.7 [P = .001]). Only the maximum
dical history. We assessed the competence of the junc- diameter of the GSV at the junction independently corre-
tion and of the treated and untreated saphenous trunk lated with ECD-confi rmed refl ux in the treated saphenous
and the presence of recurrent varicose veins. The trunk trunk or in the anterior accessory saphenous vein (odds
was considered ablated if it was nonvisible on B-mode or, ratio, 1.10; 95% confi dence interval, 1.01-1.21).
when visible, if it was noncompressible or without fl ow
or refl ux on color fl ow Doppler analysis. Any recurrent va- Conclusions:
ricose vein with the leakage point located in the treated EVLA using a 1470-nm diode laser with radial fi bers pro-
saphenous vein was considered a failure. We asked pa- vides stable and valuable long-term results in patients
tients about the eff ect of EVLA on their preoperative com- with either GSV or SSV insuffi ciency.
plaints and about any new or recurrent symptoms. We
also recorded any complication or additional subsequent Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc.
All rights reserved.
treatment and all data necessary to calculate the clini-
cal class (C of the Clinical, Etiology, Anatomy, and Patho- Published in Journal of Vascular Surgery: Venous and Lymphatic Disorders,
Available online 27 June 2020
physiology [CEAP] classifi cation) and the Venous Clinical https://doi.org/10.1016/j.jvsv.2020.06.015
Severity Score (VCSS). Finally, we investigated potential

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