Endovenous laser ablation in patients with severe primary chronic venous insufficiency.

BACKGROUND: The aim of study was to estimate the safety and efficacy of using laser wavelength of 1560 nm with the foam sclerotherapy (FS) of varicose veins (VVs) for the treatment of severe primary chronic venous insufficiency (CVI, C4-C6) in patients with different diameters of the proximal segment (DPS) of the great saphenous vein (GSV).

METHODS: We have separated the patients into two groups depending on the size of GSV: group 1 (281 cases; DPS of GSV less than 15 mm) and group 2 (210 cases; DPS of GSV more than 15 mm). Both groups received the endovenous laser ablation (EVLA) of the saphenous vein trunk, incompetent perforator veins (IPs) and FS (Tessari method) of VVs. The linear endovenous energy density (LEED) was personalized depending on the vein size.

RESULTS: The healing of ulcers and resolution of venous eczema in 6 months were considered the primary end-point. Healing of ulcers was found in 45/55 (82%) cases in group 1 and in 31/35 (88%) cases in group 2. The resolution of venous eczema in 56 (80%) from 70 cases in group 1 and 45 (85%) from 53 cases in group 2 was observed. Leg ulcer recurrence at 3 years' follow-up in 7.3% cases in group 1 and 8.6% cases in group 2 was determined.

CONCLUSIONS: Our experience of using laser wavelength of 1560 nm and FS of VVs for the treatment of severe primary CVI shows the safety and efficacy of this technique in patients with different DPS of GSV.