Comparison of Long-Term Results of Endovenous Ablation Techniques and Classical Stripping Operations in the Treatment of Venous Insufficiency
Abstract
Objectives: Chronic venous insufficiency affects approximately 25% of the population and is primarily associated with reflux in the great saphenous vein. Traditional treatments like high ligation and stripping have been effective but are burdened with complications such as postoperative pain, wound infections, and nerve damage, alongside high recurrence rates. In contrast, minimally invasive endovenous techniques, including radiofrequency ablation, endovenous laser ablation (EVLA), and ultrasound-guided foam sclerotherapy, have gained popularity due to their lower
complication rates and efficacy demonstrated in short- and medium-term studies. This study synthesizes existing literature comparing these treatment modalities and aims to evaluate the effectiveness of classical stripping and endovenous ablation techniques in the treatment of venous insufficiency.
Materials and Methods: Between October 2011 and January 2016, 832 patients underwent different procedures at Ankara University Faculty of Medicine, Department of Cardiovascular Surgery, with a total of 1,390 lower extremities treated. The study assessed patient demographics, procedural outcomes, complications, and quality of life (QoL) improvements following each intervention. Statistical analyses, including t-tests, Mann-Whitney U tests, and logistic regression, were employed to compare outcomes and identify influencing factors.
Results: The findings underscored high procedural success across all methods and significant QoL improvements post-treatment. However, no statistically significant differences were observed in QoL outcomes between treatment modalities. Complication rates varied, with EVLA showing higher rates of postoperative ecchymosis and classical stripping associated with increased wound infection incidence. Factors influencing outcomes included body mass index, bilaterality of treatment, and use of venoactive drugs.
Conclusion: The study concluded with recommendations for further randomized controlled trials to refine treatment protocols and elucidate longterm efficacy.
Keywords
Venous insufficiency, classical stripping, endovenous laser ablation, radiofrequency ablation, quality of life, complications
Ethical Statement
This retrospective study is formed according to the ethical guidelines of the 1975 Declaration of Helsinki and approved by the the Human Research Ethics Committee of Ankara University Faculty of Medicine (approval no.: İ02-154-24, date: 06.03.2024).
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