Randomized Clinical Trial Comparing Two Methods for Endovenous Laser Ablation of Incompetent Perforator Veins in Thigh and Great Saphenous Vein Without Evidence of Saphenofemoral Reflux

• Published in: Dermatologic surgery Vol. 38; no. 4; pp. 640 - 646
• Main Authors: Park, Sang Woo, Hwang, Jae Joon, Yun, Ik Jin, Lee, Song Am, Kim, Jun Seok, Chang, Seong‐Hwan, Chee, Hyun Keun, Chang, Il Soo
• Format: Journal Article
• Language: English
• Published: Malden, MA Wiley 01.04.2012
• Subjects: Aged; Biological and medical sciences; Dermatology; Endovascular Procedures - methods; Feasibility Studies; Femoral Vein; Humans; Laser Therapy; Male; Medical sciences; Middle Aged; Prospective Studies; Saphenous Vein - surgery; Skin plastic surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thigh - blood supply; Varicose Veins - surgery; Treatment; Dermatology; Saphenous vein; Surgery; Thigh; Laser; Clinical trial; Method; Ablation; Comparative study
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1111/j.1524-4725.2011.02261.x

BACKGROUND Percutaneous ablation of incompetent perforators has been introduced as a safe and efficacious alternative. Objective To compare two methods of treating incompetent thigh perforator and great saphenous veins (GSV). Materials and Methods Patients with varicose veins of CEAP C2 and C3 with incompetent perforating veins (IPVs) in the thigh without evidence of saphenofemoral reflux and with obvious venous reflux from IPVs into the GSV distal to IPVs were included. Endovenous laser ablation was done using two methods (IPV ablation (IPVA) versus GSV ablation: GSVA). Their technical success rate, clinical success rate, and complications were compared at 1 week, and 1, 3, 6, and 12 months. Results Sixty‐nine consecutive patients were randomized to IPVA (n = 34) or GSVA (n = 35). Technical success was significantly lower with IPVA than GSVA (p = .002). Clinical success, defined as continued closure of treated veins, was similar with IPVA and GSVA (96.1% vs 100% at 1 week, 100% vs 97.1% at 1 month, and 100% for both at 3, 6, and 12 months, respectively). Conclusion IPVA has clinical results and complications similar to those of GSVA in individuals with C2 and C3 chronic venous disease with IPVs in the thigh combined with incompetent GSV, but its higher technical failure rate makes it difficult to choose it as the primary treatment method.