Recurrence of Varicose Vein after Endovenous Laser Therapy in a Tertiary Care Center: A Descriptive Cross-sectional Study

Introduction: Varicosity is the common problem of various etiology having simple limb aching to worst complications like oedema, ulcer, and skin changes. Minimal invasive endovenous laser therapy is a noble procedure. The aim of the study is to find out the recurrence of the varicose vein after laser therapy in a tertiary care center. Methods: This descriptive cross-sectional study was done in 38 patients with varicosity of the lower limb in a tertiary care hospital, from January 2019 to June 2019 after taking ethical clearance from Institutional Review Committee. Convenience sampling was done. Data was collected and entry was done in Statistical Package for the Social Science software version 22, point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Results: We recorded 38 patients with ablated limb out of which none of the ablated veins showed recanalization in six months follow up. Twenty two (58%) patients were male and 16 (42%) patients were female with a mean age of 40.26 years. Major bulk, 23 (60.5%) resumed activity in second postoperative day and only 1 (2.6%) patient waited for 5 days for normal activity with mean of 2.58 days postoperatively. Sixteen (42.1%) patients developed erythema or ecchymosis, 12 (31.6%) patients had induration along the long saphenous vein course, 7 (18.4%) patients had paresthesia, 2 (5.3%) patients had limb swelling and 1 (2.6%) patient had skin burn. Conclusions: Endovenous laser ablation has very low rate of recurrence of varicosity and has minorcomplications.

The Endovenous Laser Therapy for the Management of Varicose Veins

Introduction: Varicose veins of the lower limb are common condition affecting majority of people worldwide and has great effect on quality of life. The definitive therapy being surgery with stripping of the veins which is associated with surgical complications, prolong recovery time and significant recurrence. Endovenous laser therapy (EVLT) is a minimally invasive procedure which is widely used for the treatment of varicose veins with excellent results.Objective: To evaluate the safety and efficacy of EVLT for the management of varicose veins.Methodology: This was a prospective study of 40 patients who underwent endovenous laser therapy at the affiliated hospital of Inner Mongolia University for the Nationalities from October 2016 to September 2017. All patients with primary symptomatic varicose veins with sapheno-femoral incompetence or great saphenous vein (GSV) reflux were included in the study. The patient's information and data were recorded during the hospital stay in the proforma for EVLT with the informed consent. The variables used were mean operating time, intra-operative blood loss, duration of hospital stay, return to normal activity, complications and the recanalization. Following discharge, the patients were followed up to six months.Results: Forty patients with unilateral varicose veins were treated with EVLT. There were 24 female and 16 male with mean age of 52 yrs and the majority of patients having symptoms for more than five years. The mean operative time and intra-operative blood loss were 80 minutes and 52 ml respectively. The mean duration of hospital stay was 2.5 days with 90% patients returning to the normal activity in 10 days. Swelling and indurations were the most common complication in 10 patients followed by hypoesthesia in 8, ecchymosis in 7 and skin burn in 4 patients.Conclusion: EVLT seems to be safe and effective minimally invasive procedure with excellent clinical outcome in terms of lower postoperative pain, early return to normal activities and fewer complications. However large sample size with long follow up study should be conducted for evaluating long term benefits. BJHS 2018;3(2)6:437-442.

EVLT with foam sclerotherapy for varicose veins: a single unit study

Background: The true incidence of varicose veins in our country is not known as majority of patients with mild to moderate varicosities do not report to the physicians and only patients with complication like eczema, ulceration and bleeding are seen in clinics and hospitals. The search for a more effective means of prevention and for the perfect cure for this common condition continues. The aim of this study was to assess feasibility of Endovenous laser therapy with foam sclerotherapy for varicose veins with SFJ/SPJ incompetence.Methods: Out of two hundred and fifty (n = 250), the most common age group was between 31-40 years. 68% were females. Left limb was more affected. The patients presented with varied symptoms, out of which painless dilated and tortuous veins was most common. Long Saphenous system was the most common venous system affected by varicosity. The median operating time for one system was 35 mins. Visual analog scale for pain (VAS) was median 1 at 24 hours. 25 patients had pain for 2 weeks, 30 patients had ecchymosis, 45 patients had neuralgia, 35 patients had pain, none of the patients had skin burns and one (1) patient developed DVT. Mean hospital stay was 1 day. Follow up at 3 months showed, no pain and no scar.Results: In this retrospective study, we found that incidence of colorectal carcinoma is more between 40-60 years of age with male predominance; lymph node metastasis is more than metastasis in any other sites. CT scan can diagnose lymphatic metastasis and infiltration in surrounding tissue more accurately. Percentage of sphincter saving procedure were low in rectal malignancies in our study.Conclusions: At present, endovenous laser ablation with Foam Sclerotherapy of both the GSV and SSV shows considerable promise in the treatment of varicose veins. Avulsion is not required. The advantages of this procedure include ease, safety, cosmesis and durability.