Twenty Years’ Experience with Endovenous Laser Ablation for Varicose Veins: A Critical Appraisal of the Original Procedure

2021 ◽  
Vol 39 ◽  
Author(s):  
Bernardus Disselhoff ◽  
◽  
Daan der Kinderen ◽  
Keyword(s):  
Patient Satisfaction ◽  
Laser Ablation ◽  
Critical Appraisal ◽  
Varicose Veins ◽  
Infusion Pump ◽  
Ambulatory Setting ◽  
High Ligation ◽  
Safe Procedure ◽  
Endovenous Laser Ablation ◽  
Original Procedure

Objective: A critical appraisal of the original procedure of endovenous laser ablation (EVLA) for varicose veins. Method: Evaluation of all practical aspects of the procedure. Results: EVLA procedures are performed in a strictly ambulatory setting with tumescent local anesthesia (TLA). Technical improvements have resulted in the need for fewer incisions and re-punctures, less ecchymosis, and fewer technical failures. Administration of an appropriate amount of TLA via an infusion pump has reduced the risk of nerve injury, administration time, and pain during the procedure. Use of a 1470-nm diode laser and a radial fiber have significantly improved patient satisfaction and reduced the occurrence of complications such as pain, tightness, ecchymosis, and the need for additional procedures. Lastly, there are only a few indications left for high ligation and stripping. Conclusion: Over the past 20 years, EVLA has evolved into an effective, cost-efficient, and safe procedure that provides high patient satisfaction.

scholarly journals Endovenous laser ablation for great saphenous varicose veins

2019 ◽  
Vol 6 (12) ◽  
pp. 4502
Author(s):  
Asser Abd El Hamid Goda
Keyword(s):  
Laser Ablation ◽  
Clinical Examination ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Main Trunk ◽  
Endovenous Laser Ablation ◽  
Venous Clinical Severity Score ◽  
The Mean

Background: Endovenous laser ablation (EVLA) is one of the most accepted treatment options for great saphenous varicose veins. The aim of this study was to evaluate the efficacy and safety EVLA in a 12 months follow-up.Methods: Patients with symptomatic great saphenous veins (GSV) reflux were undergo EVLA. The outcome measures the efficacy and safety along the follow up period (12 months). The efficacy assessed by measuring the occlusion rate of the GSV by duplex and by measuring the improvement in the mean venous clinical severity score (VCSS) by clinical examination. The safety assessed by clinical examination to detect the complications.Results: The rate of complete occlusion in the main trunk of the great saphenous vein was 34/35 (97.1%) at 6 and 12 months. The mean VCSS scores improved significantly after the procedure at 6 and 12 months. Complications detected within 1st week as pigmentation in 3 patients, local hematoma in one patient, and paresthesia in one patient but all complications disappeared within 6 and 12 months.Conclusions: EVLA is an effective and safe procedure for the treatment of varicose great saphenous. 

scholarly journals Heat-induced thrombosis extension after endovenous laser ablation: a clinical case

2020 ◽  
Vol 27 (4) ◽  
pp. 179-188
Author(s):  
A. A. Fokin ◽  
D. A. Borsuk ◽  
A. V. Sazanov ◽  
H. P. Manjikyan
Keyword(s):  
Laser Ablation ◽  
Clinical Case ◽  
Varicose Veins ◽  
High Ligation ◽  
Anticoagulant Treatment ◽  
Oral Anticoagulant Treatment ◽  
Endovenous Laser Ablation ◽  
Choice Of Treatment ◽  
Minor Surgery ◽  
The Right

Endothermal heat-induced thrombosis (EHIT) is a complication of endovenous thermal ablation in treatment of varicose veins. Existing classifications do not account for the length of thrombus extension floating in the deep venous system. While the risk of extension is minor, the consequences can be baleful.Aim. To report a rare clinical case of endothermal heat-induced thrombosis extension formed in spite of ongoing anticoagulant treatment in a patient with endovenous laser ablation.Results. A 39 years-old man with endovenous laser ablation of the right great saphenous vein had class 2 EHIT with 1.92 cm length on the next day after surgery. Rivaroxaban was prescribed at a dose of 15 mg 2 times a day. EHIT extension above the inguinal ligament occurred on the 15th day after surgery, despite oral anticoagulant treatment. Open thrombectomy with high ligation was ordered. Postoperative period without complications. Preoperative Caprini score was 6 (varicose veins, BMI> 25 kg/m2 , minor surgery, personal history of venous thromboembolism (VTE)).Conclusion. The reported clinical case illustrates that both the choice of treatment strategy and follow-up of patients with EHIT need to account for the combined risk of embolism with existing EHIT and potential thrombus extension with subsequent massive embolism.

scholarly journals Evaluation of Endovenous Laser Ablation in Management of Varicose Veins

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
T I Ouf ◽  
M A Nada ◽  
A M Salem ◽  
N Y Elzefzaf
Keyword(s):  
Laser Ablation ◽  
Varicose Veins ◽  
Recovery Period ◽  
Minimal Invasive ◽  
High Ligation ◽  
Minor Complication ◽  
Endovenous Laser Ablation ◽  
Invasive Method ◽  
Primary Varicose Veins ◽  
Promising Line

Abstract Background There have been tremendous changes to the treatment of varicose veins over the years. High ligation of the SFJ and stripping of the GSV have been considered as standard treatments for GSV insufficiency for more than one century and it is still adopted as the preferred method in the majority of the surgical centers. Aim of the Work To discuss the advances in the treatment of varicose veins and their advantages over traditional methods in an attempt to choose the best method of treatment with least complications and highest success rate of cure and to review the recently advanced endovenous laser ablation as a promising line of management of primary varicose veins. Patients and Methods This observational prospective was conducted on 30 patients 30 patients with varicose veins in multiple centers carrying out endovenous laser ablation.during the period from October 2017 till March 2018. Results After the EVL ablation +/- sclerotherapy, no major complications occurred, minor complication however, was quite common and included bruising (33.3%), ecchymosis (16.6%), postoperative pain (66%) that require analgesic, superficial thrombophlebitis (16.6%) and skin burn (3.3%). Conclusion EVLA is continuing to be an outstanding minimal invasive method for treatment of varicose veins with minimal complications and a very short recovery period which sounds appealing to the patients.

Conventional surgery and endovenous laser ablation of recurrent varicose veins of the small saphenous vein: a retrospective clinical comparison and assessment of patient satisfaction

2010 ◽  
Vol 25 (3) ◽  
pp. 151-157 ◽  
Author(s):  
L van Groenendael ◽  
L Flinkenflögel ◽  
J A van der Vliet ◽  
E A Roovers ◽  
S M M van Sterkenburg ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Laser Ablation ◽  
Saphenous Vein ◽  
Sural Nerve ◽  
Varicose Veins ◽  
Treatment Modalities ◽  
Complication Rates ◽  
Endovenous Laser Ablation ◽  
Recurrent Varicose Veins

Objectives Recurrences of varicosities of the small saphenous vein (SSV) are common. Surgical reintervention is associated with increased complication rates. The aim of the study was to assess the feasibility of endovenous laser ablation (EVLA) in recurrent varicose veins of the SSV and to compare this technique with surgical reintervention. Methods All case files of patients treated for SSV varicosities between May 2006 and October 2008 were evaluated and recurrences were selected. Demographics, duplex findings, clinical, aetiological, anatomical and pathological classification, perioperative and follow-up data were all registered. Additionally, a questionnaire focusing on patient satisfaction was taken. Results Two hundred and eighty-one patients were treated for varicosities of the SSV, of which 42 were for recurrences. Twenty-six of these were treated with EVLA, all under local anaesthesia, and 16 were surgically treated. Most surgically treated patients were treated under regional anaesthesia (88%). Technical success was achieved in 94% of surgically treated patients and in all EVLA-treated patients. Complications in both groups were mostly minor and self-limiting. Sural nerve neuralgia appeared to be more frequent in the surgically treated group (20% versus 9%). After correction for length of follow-up, the incidence of rerecurrences was not statistically significant between groups. Conclusion EVLA is feasible in patients with recurrent varicose veins of the SSV with possibly a lower incidence of sural nerve injury. Patient satisfaction is high for both treatment modalities. Studies with larger samples are indicated to confirm these observations.

scholarly journals The Management of Varicose Veins

2015 ◽  
Vol 100 (1) ◽  
pp. 185-189 ◽  
Author(s):  
Fan Lin ◽  
Shiyi Zhang ◽  
Yan Sun ◽  
Shiyan Ren ◽  
Peng Liu
Keyword(s):  
Radiofrequency Ablation ◽  
Laser Ablation ◽  
Varicose Veins ◽  
Controlled Study ◽  
High Ligation ◽  
Foam Sclerotherapy ◽  
Current Management ◽  
Endovenous Laser Ablation ◽  
Randomized Controlled ◽  
Better Than

Abstract This study aimed to review the current management modalities for varicose veins. There are a variety of management modalities for varicose veins. The outcomes of the treatment of varicose veins are different. The papers on the management of varicose veins were reviewed and the postoperative complications and efficacy were compared. Foam sclerotherapy and radiofrequency ablation were associated with less pain and faster recovery than endovenous laser ablation and surgical stripping. Patients undergoing endovenous laser ablation and radiofrequency ablation are most likely to have a faster recovery time and earlier return to work in comparison with those undergoing conventional high ligation and stripping. A randomized controlled study in multiple centers is warranted to verify which approach is better than others for the treatment of varicose veins.

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