Endovenous laser ablation (EVLA) versus high ligation and striping (HL/S): Two-years follow up

Endovenous laser ablation (EVLA) of the great saphenous vein (GSV) is thought to minimize postoperative morbidity and reduce work loss compared with high ligation and stripping (HL/S). However, the procedures have not previously been compared in a trial with parallel groups where both treatments were performed in tumescent anesthesia on an out-patient basis. Patients with varicose veins due to GSV insufficiency were randomized to either EVLA (980 nm) or HL/S in tumescent anesthesia. Miniphlebectomies were also performed. In our clinics, 87 varicosis patients were treated between September 2006 and December 2009. EVLA was applied in 90 cases and HL/S was applied in 84 cases. Clinical features and demographic characteristics of the patients were summarized. EVLA procedure was done by 980 nm diode laser (Ceralas D 980, Biolitec) at continues mode with 15 W energy. Patient visits were done at post-operative 10th day, 6th month, 1st year and 2nd year. Routine physical examination and Doppler USG assessments were performed at these visits. EVLA and HL/S procedures were done in complete success in all cases at both groups. All cases were invited for control visits. At post-operative 10th day all patients were evaluated, at 1st year control visit number of attended patients was 130 (EVLA: 68, HL/S: 62) and at 2nd year control, visit number of attended patients was 104 (EVLA: 56, HL/S: 48). When complications developed after procedures were evaluated; no infection, hematoma or paresthesis were observed in EVLA group. However in HL/S group; infections, hematomas and paresthesis were observed in 2, 6 and 24 cases respectively. In terms of treatment success there was not significant difference between EVLA procedure and HL/S methods. However, in terms of post-op complication, EVLA method was associated with significantly less paresthesis, hematoma and pain. EVLA method is a method as effective and safe as standard treatment. However, when a long term result of this method is shown completely, its effectiveness will be cleared and its clinical utility will be established.