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Online ISSN 1827-1847
LATEST INSIGHTS IN ENDOVASCULAR SURGERY
Darvall K. A. L.
Department of Vascular Surgery, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust, Taunton, UK
Over the last decade many endovenous techniques have been developed for the treatment of superficial venous insufficiency, in order to improve the side-effect profile of superficial venous surgery, shorten recovery times and increase durability. This review outlines the available techniques, focussing mainly on endovenous laser ablation, radiofrequency ablation and ultrasound-guided foam sclerotherapy. The evidence for the different techniques is discussed, including technical (anatomical) success in the short- and long-term; changes in clinical status (including symptom relief and cosmesis); improvements in health-related quality of life; patient satisfaction; and cost, both in terms of time away from normal activities and direct cost of treatment as measured in cost-effectiveness analyses. The side-effects and complications of the various techniques are discussed. While most available data focus on primary great saphenous treatment; the evidence for treatment of recurrent VV and small saphenous varicose veins is also discussed.