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Online ISSN 1827-1766
Phlebological Unit, Department of General Surgery, University of Siena, Siena, Italy
AIM: The aim of this paper was to assess the clinical experience and 10-year-instrumental results of varicose veins treated with endovenous laser ablation (EVLA) of great saphenous vein.
METHODS: From December 2001 to February 2005, 167 patients (126 F e 41 M), affected by varicose veins due to incompetence of great saphenous vein (GSV) detected by Duplex ultrasound scanning (DUS), were treated with EVLA at our Center. EVLA was performed at the beginning of our experience using an 810-nm diode laser (Diomed, NJ, USA) on 66 patients. After January 2004, a 980-nm diode laser (Team laser, Padua, Italy) was used on the other 101 patients.
RESULTS: We recorded no intraprocedural complications. We detected at 24-hours clinical follow-up 29 cases (17%) of bruising of the thigh, which rapidly disappeared after a few days. 25 patients (15%) complained of light pain at the treated lower limb appeared, which 3-4 days after the procedure and lasted more than a week. At 1, 6 and 12 months DUS control the GSV obliteration was observed in 154/164 patients (94%). At 3-years follow-up the GSV was successfully occluded in 139/151 patients (92%), while at 5-years follow-up the same was occluded in 102/118 patients (86%). At 10-years instrumental follow-up we detected 11/110 cases (10%) of the GSV recanalization and 5/110 patients (4.5%) with recurrent varicose veins in the lower limb operated.
CONCLUSION: The EVLA represents a safe and effective technique for the correction of GSV reflux and it can be seen as a good alternative to traditional surgery, expecially if we respect the right indications. Our experience has shown, looking at the long-term results, that the endovascular obliteration of GSV presented excellent results, comparable with traditional open surgery.