This article is more than 5 years old. Information may no longer be current.

Outcomes using high ligation similar with stripping vs. endovenous laser ablation of GSV

Patients who underwent high ligation and stripping or high ligation and endovenous laser ablation of the great saphenous vein experienced good clinical outcomes with no significant differences at 5-year follow-up in a recent study.

“The patients’ satisfaction after varicosity surgery was high 2 to 5 years postoperatively. Clinical results … are favorable after both treatment methods,” Manfred Kalteis, MD, department of surgery at BHS Hospital in Austria, and colleagues wrote in Dermatologic Surgery. “No major difference was noted between groups.”

Kalteis and colleagues randomly assigned 100 patients to high ligation and stripping (HL + S) or high ligation and endovenous laser ablation (HL + EVLA) of the great saphenous vein (GSV). They used an 810-nm diode laser for patients who received HL + EVLA.

At 5-year follow-up, the researchers noted the Clinical-Etiology-Anatomy-Pathophysiology (CEAP-C) classification and Venous Clinical Severity Score (VCSS), CIVIQ2 global index score of each patient as well as recurrence of visible varicose veins and reoperations. The researchers also recorded patient and surgeon satisfaction and cosmetic outcome for each group.

They found that 88% of HL + S patients and 80% of HL + EVLA patients had normal postoperative results with no complications, and they needed no further treatment. In addition, 83.3% of patients in the HL + S group and 93.3% of patients in the HL + EVLA group reported they would undergo the same treatment again.

Fifty-five percent of HL + S patients and 40% in the HL + EVLA group had recurring varicose veins of any kind; however, no patients required reoperation. Further, 67% of patients in the HL + S group and 43% of patients in the HL + EVLA group showed no signs of varicosity or venous insufficiency identified by duplex ultrasound.

“The procedures are also associated with a very high degree of patient satisfaction,” Kalteis and colleagues wrote. “However, recurrences remain a problem with both methods. Especially, at follow-up investigations using duplex ultrasound, many patients show signs of truncal or groin recurrence. The clinical relevance of these findings can be established only after further observation in the long term.” – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.