Efficacy of Endovenous Laser Ablation and Ultrasound-Guided Foam Sclerotherapy in Patients with Great Saphenous Vein and Perforating Vein Insufficiency

Abstract

Aim: In this study, we aimed to investigate the efficacy of endovenous laser ablation (EVLA) and EVLA combined with ultrasound-guided foam sclerotherapy (UGFS) and outcomes of treatments in patients with great saphenous vein (GSV) and perforating vein (PV) insufficiency. Material and Method: Patients underwent EVLA and EVLA+UGFS at the Interventional Radiology Department of a tertiary referral hospital over a 2-year period were retrospectively analysed. Lower limbs of patients were divided into 2 groups according to the treatment method: lower limbs underwent EVLA (group 1) and EVLA+UGFS (group 2). Before and after the procedures, GSVs and incompetent PVs were assessed by colour Doppler ultrasound. Chronic venous insufficiency symptoms (CVIS): pain, heaviness, night cramps, fatigue, itching, burning sensation, swelling, numbness, tingling and visual analogue scale (VAS) scores were assessed before and at 6 months after treatment. Results: The study group included 29 female (69.1%) and 13 male (30.9%) patients with a mean age of 49.8±12.5 years (range, 24-73 years). All treated GSVs and IPVs were occluded at 6 months after procedures. Improvement in one or more CVIS was observed in all limbs. Full recovery in CVIS was 11/38 (28.9%) in group 1 and 2/9 (22.2%) in group 2. No significant difference was found between the two groups in the comparison of the percentage reduction in the rate of full recovery of symptoms (p>0.05). The VAS scores were significantly decreased after procedures in group 1 and 2 (p=0.0001 and 0.007, respectively). The difference in the percentage decrease in VAS scores in the 6th month compared to before treatment was not statistically different between the two groups (p>0.05). Conclusion: EVLA and UGFS are highly effective and reliable treatments for GSV and PV insufficiency. EVLA+UGFS treatments provide similar improvements in CVIS in lower limbs with GSV and PV insufficiency. Patients with lower clinical severity, treatment only for GSV insufficiency may be considered instead of concomitant treatment of GSV insufficiency and PVI.

Keywords

• Endovenous laser ablation
• ultrasound-guided foam sclerotherapy
• great saphenous vein
• varicose vein
• perforating vein insufficiency

Kaynakça

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