The multimodal treatment approaches to varicose veins: Preservation versus thermal ablation of the incompetent great saphenous vein

• Auteurs principaux: Ihar Ihnatovich (Auteur), Genadz Kandratsenka (Auteur), Julia Dabravolskaj (Auteur), Katsiaryna Ihnatovich (Auteur), Natallia Novikava (Auteur)
• Format: Livre
• Publié: International Journal of Vascular Surgery and Medicine - Peertechz Publications, 2022-01-04.
• Sujets: Research Article
• Accès en ligne: Connect to this object online.

<p>Objective: To compare the clinical efficacy of Ambulatory Selective Varices Ablation under Local Anesthesia (ASVAL) and Endovenous Laser Ablation (EVLA) with concomitant phlebectomy in patients with the incompetent Great Saphenous Vein (GSV).</p><p>Design: "Prospective Case Series study (C2-C3 patients) with 2 and 5 years follow-up.</p><p>Methods: This was a prospective observational cohort study in a single center. Seventy-six patients (59 females) with GSV incompetence and C2-C3 were included in the prospective consecutive case study. The diameter of GSV at the 15-cm below the SFJ level was the main criterion to identify two groups of patients. Thirty-three patients (25 females, mean age 37.03) with the GSV diameter ≤6 mm were treated with ASVAL. Forty-three patients (34 females, mean age 46.19) with the GSV diameter >6 mm were treated by EVLA with concomitant phlebectomy. Clinical and functional outcomes measured by Venous Clinical Severity Score (VCSS) and clinical recurrence-free rate according to the classification of recurrent varicose veins after treatment (PREVAIT) were analyzed in 2 years follow-up. The clinical recurrence-free rate was analyzed in 5 years follow-up.</p><p>Results: 2-year follow-up was detected a significant decrease in the postoperative VCSS in the ASVAL and the EVLA group (p< 0.001). There was no statistically significant difference between both groups in VCCS in 2 years post-operation (p= 0.681). Frequency of recurrence did not differ between ASVAL (18.8%) and EVLA (21.4%) groups 2 years after treatment (p= 0.776) and the diameter of the GSV significantly decreased in the ASVAL group (5.48 vs 5.13, p= 0.008). The 5-year follow-up was detected recurrences in 40.0% of patients ASVAL group and 45.6% EVLA group (p = 0.668). </p><p>Conclusions: Both ASVAL and EVLA effectively improve the disease severity in the groups of patients, selected according to the GSV diameter (≤ 6 mm or > 6 mm).</p>