Study Compares Great Saphenous Vein Insufficiency Therapies

More adverse events with laser, but advantages in hemodynamics, recovery, cosmetic outcome

THURSDAY, Sept. 22 (HealthDay News) -- Endovenous laser treatment (EVLT) and high ligation and stripping (HLS) are equally safe and effective in treating great saphenous vein (GSV) insufficiency, according to a study published online Sept. 19 in the Archives of Dermatology.

Knuth Rass, M.D., from Saarland University Hospital in Homburg, Germany, and colleagues compared the clinical efficacy and safety of EVLT with HLS as a standard treatment for GSV insufficiency. From September 2004 through March 2007, patients with GSV insufficiency were assigned to treatment with EVLT (n = 185) or HLS (n = 161). Outcomes measured included clinically recurrent varicose veins after surgery, duplex-detected saphenofemoral recurrence, clinical venous severity scoring, hemodynamics, quality of life (QOL), adverse effects, and visual analog scale-based evaluations of patients' satisfaction.

The investigators identified statistically similar occurrence of clinically recurrent varicose veins after surgery in the EVLT- and HLS-treated groups (16.2 and 23.1 percent, respectively). Equal improvements were noted in medical condition and disease-related QOL between the groups. Significantly more frequent duplex-detected saphenofemoral refluxes occurred after EVLT (17.8 versus 1.3 percent). More adverse events, including phlebitic reaction, tightness, and dyspigmentation occurred after EVLT, but EVLT had advantages over HLS regarding hemodynamics, recovery, and cosmetic outcome.

"Both EVLT and HLS are comparably safe and effective procedures to treat GSV incompetence," the authors write.

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