Rev Med Suisse 2017 Mar;13(554):618-622

Service d'angiologie, CHUV, 1011 Lausanne.

Interventional treatment of venous insufficiency has been revolutionized by endovascular techniques. Some of these techniques, and particularly thermal ablation (endovenous laser, radiofrequency) are now recommended as first-line therapy in the latest international guidelines. This is because of less post-operative pain, a shorter leave from employment and similar or lower recurrence rate. Read More

J Vasc Surg Venous Lymphat Disord 2017 Jul 12;5(4):525-532. Epub 2017 May 12.

Division of Vascular Surgery, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.

Background: The Effect of Surgery and Compression on Healing and Recurrence (ESCHAR) trial previously reported that patients with venous leg ulcers treated with saphenous stripping experienced a significantly reduced incidence of ulcer recurrence compared with patients treated with compression therapy. Most patients with leg ulcers and saphenous insufficiency are currently treated with endovenous thermal ablation (EVTA), but little information is available on the long-term results after EVTA in Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) clinical class 5 (C5) and class 6 (C6) patients.

Methods: We retrospectively reviewed all CEAP C5 or C6 patients treated with EVTA to define the incidence of ulcer healing and recurrence. Read More

Pediatr Radiol 2017 May 18. Epub 2017 May 18.

Image Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Background: Endovenous laser ablation is well recognized as the first-line treatment for superficial venous reflux with varicose veins in adults. It is not widely reported and is not an established practice in pediatric patients.

Objective: To illustrate a variety of pediatric venous conditions in which endovenous laser ablation can be utilized and to demonstrate its feasibility and safety in children. Read More

J Vasc Surg Venous Lymphat Disord 2017 May 6;5(3):339-345. Epub 2017 Mar 6.

Department of Surgery, New-Tokyo Hospital, Chiba, Japan.

Background: The aim of the study was to evaluate the clinical results and postoperative complications, especially recanalization or bleeding complications, in patients with saphenous varicose veins undergoing endovenous laser ablation (EVLA) while receiving antithrombotic therapy (ATT).

Methods: This retrospective cohort study included 1136 Japanese patients undergoing EVLA with a 980-nm diode laser between January 2012 and November 2015 at our institution. The patients were divided into two groups: ATT users (ATT group) and nonusers (control group). Read More

J Vasc Surg Venous Lymphat Disord 2017 May 6;5(3):321-330. Epub 2017 Mar 6.

Inovia Vein Specialty Center, Bend, Ore.

Objective: Endovenous cyanoacrylate closure (CAC) is a new U.S. Food and Drug Administration-approved therapy for treatment of clinically symptomatic venous reflux in saphenous veins. Read More

Biomed Res Int 2017 20;2017:6167480. Epub 2017 Feb 20.

Department of General and Vascular Surgery, Poznań University of Medical Sciences, Długa 1/2 Str., 61-848 Poznań, Poland.

Here we compared effect of serum from varicose patients undergoing endovenous laser ablation (EVLA) and classic vein stripping (CVS) on biological properties of endothelial cells and on the local and systemic profiles of proinflammatory agents. Results showed that serum from EVLA patients improved proliferation and reduced senescence and oxidative stress in the endothelial cells, as compared with the serum from CVS patients. These effects were related to a suppressed activity of TGF-β1, the level of which in the serum from the EVLA patients was decreased. Read More

J Vasc Surg Venous Lymphat Disord 2017 Mar 12;5(2):210-215. Epub 2017 Jan 12.

Department of Cardiovascular Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.

Objective: The endovenous application of n-butyl cyanoacrylate (NBCA) is a new nontumescent ablation technique for the treatment of venous insufficiency. The aim of this study was to retrospectively compare an NBCA-based ablation method with endovenous laser ablation (EVLA) for the management of incompetent great saphenous veins.

Methods: Between May 2013 and August 2014, there were 339 patients with incompetent varicose veins who were treated with either the endovenous application of NBCA (VariClose Vein Sealing System [VVSS]; Biolas, Ankara, Turkey) or EVLA. Read More

Int J Surg 2017 Mar 21;39:267-275. Epub 2017 Jan 21.

Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing 100853, China.

Purpose: To investigate and compare the relative efficacy, recurrence and complications of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) for the treatment of varicose veins patients.

Methods: Searches were applied to the Cochrane Library as well as MEDLINE, EMBASE, BIOSIS databases. 12 articles published in English (10 randomized controlled trials and 2 cohort study) were identified from specialized trails. Read More

Vasa 2017 Mar 16;46(2):96-100. Epub 2016 Dec 16.

1 Praxis für Innere Medizin und Gefäßkrankheiten, Halle (Saale), Germany.

Treating varicose veins using endovenous thermal techniques - especially laser and radio frequency ablation - has emerged as an effective alternative to open surgery with stripping and high ligation. Even though these methods are very gentle and patient-friendly, they are nevertheless accompanied by risks and side effects. Compared to open surgical therapy, the risk of damage to peripheral and motor nerves is reduced; however, it still exists as a result of heat exposure and tumescent anaesthesia. Read More

Angiol Sosud Khir 2016;22(4):97-101

Department of Pathological Anatomy and Forensic Medicine of the South Ural State Medical University under the Public Health Ministry of the Russian Federation, Chelyabinsk, Russia.

Aim: The study was aimed at assessing efficacy of using rivaroxaban for treatment of endothermal heat-induced thrombosis (EHIT) after endovenous laser ablation (EVLA) of saphenous veins.

Material And Methods: Our prospective study included a total of 1,326 patients subjected to 1,514 EVLAs. In 1,091 (72. Read More

Cochrane Database Syst Rev 2016 11 29;11:CD010878. Epub 2016 Nov 29.

Academic Vascular Unit, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK, S1 4DA.

Background: Short (or small) saphenous vein (SSV) varices occur as a result of an incompetent sapheno-popliteal junction, where the SSV joins the popliteal vein, resulting in reflux in the SSV; they account for about 15% of varicose veins. Untreated varicose veins may sometimes lead to ulceration of the leg, which is difficult to manage. Traditionally, treatment was restricted to surgery or conservative management. Read More

Swiss Med Wkly 2016 12;146:w14360. Epub 2016 Nov 12.

Department of Angiology, University Hospital, Basel, Switzerland.

Varicose veins of the lower extremity (VVLE) are a frequently encountered vascular disorder in the general population. The general view that VVLE are a non-serious disease with primarily aesthetic impact is a common misconception, as the disease can have a significant negative impact on generic and disease-specific quality of life. Further, VVLE may be associated with potentially threatening clinical conditions, such as chronic venous ulceration, venous thromboembolism and haemorrhage from ruptured varicose veins. Read More

Laser Ther 2016 Oct;25(3):171-177

Department of Operation Team, International University of Health and Welfare, Shioya Hospital.

Background and aims: In Japan, stripping under general anesthesia, lumbar anesthesia and tumescent local anesthesia has been used in the treatment of primary varicose veins due to saphenous vein insufficiency. However endovenous laser ablation (EVLA) using a 980 nm diode laser has received National Health Insurance (NHI) coverage in 2011, while EVLA using a 1470 nm diode laser with a radial 2-ring fiber has received coverage in 2014. As a result, the use of EVLA has become widespread in Japan. Read More

Vascular 2016 Dec 28;24(6):649-657. Epub 2016 Apr 28.

Department of Surgery, Kanizsai Dorottya Hospital, Nagykanizsa, Hungary

Objective: The aim of this review article was to evaluate the long-term technical success rates of the known endovenous ablation procedures in the treatment of the incompetence of the great saphenous vein.

Methods: A literature search was conducted in the PubMed-database until the 5 January 2016. All publications with four to five years follow-up were eligible. Read More

Ann Vasc Surg 2017 Feb 22;39:286.e11-286.e14. Epub 2016 Sep 22.

Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan.

We report a case of pulsatile varicose veins successfully managed by endovenous laser treatment (EVLT) of the great saphenous vein (GSV). A 77-year-old woman taking an anticoagulant was transferred to our hospital for pulsatile varicose veins complicated with repeated venous bleeding from an ulcer of her left lower leg. Doppler echocardiography showed severe tricuspid regurgitation, and duplex ultrasonography revealed an arterial-like pulsating flow in the saphenofemoral junction and along the GSV, but an arteriovenous fistula, obstruction of the deep veins, and the distal incompetent perforators were not detected. Read More

Int Angiol 2016 Dec 29;35(6):599-604. Epub 2015 Sep 29.

Department of Vascular Surgery, Children ABC Hospital, Mater Dei Hospital and Vascular BH Institute, Belo Horizonte, Brazil -

Background: The aim of this study was to compare venous occlusion rates at a one-year follow-up comparing 1920-nm versus 1470-nm endolaser.

Methods: Randomized prospective study with consecutive patients with varicose veins associated to great saphenous reflux. The 1470-nm laser ablation was performed in continuous mode, with power of 10 W, while for the 1920-nm it was set in 5 W. Read More

Eur J Vasc Endovasc Surg 2016 Dec 17;52(6):847-853. Epub 2016 Oct 17.

Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine, Vascular Center of Shanghai JiaoTong University, Shanghai, China. Electronic address:

Objective: The hypothesis that post-operative short-term compression therapy improves operation related complications in patients with uncomplicated varicose veins after endovenous laser ablation (EVLA) treatment was tested.

Methods: In this randomized trial, patients with uncomplicated varicose veins (C2 according to the CEAP classification) treated with EVLA at a single institution from January 2012 to November 2013 were enrolled. Before EVLA, patients were randomized into two groups based on whether or not (control group) they wore an elastic compression stocking (ECS group) post-operatively. Read More

J Endovasc Ther 2017 02 15;24(1):156-158. Epub 2016 Oct 15.

1 Vascular Service, Changi General Hospital, Singapore.

Lakartidningen 2016 10 4;113. Epub 2016 Oct 4.

Narva Kirurg Center - Stockholm, Sweden Narva Kirurg Center - Stockholm, Sweden.

Modern management of varicose veins Chronic venous disease is a common medical condition and occurs in about one-third of the adult population. Reflux, and to a much lesser extent obstruction of the superficial and deep venous systems, generates venous hypertension. The goal of the treatment is to reduce venous hypertension in order to prevent complications, progression of venous disease and to improve patients' quality of life. Read More

Vasc Endovascular Surg 2016 Oct 28;50(7):475-483. Epub 2016 Sep 28.

First Department of General and Vascular Surgery, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warsaw, Poland.

Introduction: Thermal ablation techniques have gradually replaced Babcock procedure in varicose vein treatment.

Aim: A comparative quantitative-qualitative analysis of complications and failure of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in a 5-year follow-up.

Materials And Methods: One hundred ten adult participants with varicose veins clinical grade C2 to C6, treated for isolated great saphenous vein (GSV) or small saphenous vein (SSV) insufficiency in a single lower extremity in 2009 to 2010, were enrolled and subdivided into EVLA (n = 56) and RFA (n = 54) groups. Read More

J Vasc Surg Venous Lymphat Disord 2016 Oct 8;4(4):416-21. Epub 2016 Aug 8.

Department of Vascular Surgery, University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, United Kingdom. Electronic address:

Objective: The aim of this preliminary study was to document the effect of treated great saphenous vein (GSV) length on short-term outcomes using freedom from secondary intervention as a marker.

Methods: Analysis was performed of a prospective database of endovascular laser therapy (EVLT) procedures performed by a single surgeon in an NHS hospital setting using a standardized technique in a series of consecutive ambulatory patients. During a 2-year period, 131 episodes with sufficient data were recorded. Read More

Br J Surg 2016 Oct 26;103(11):1438-44. Epub 2016 Aug 26.

Department of Vascular Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.

Background: Endovenous ablation techniques and ultrasound-guided foam sclerotherapy (UGFS) have largely replaced open surgery for treatment of great saphenous varicose veins. This was a randomized trial to compare the effect of surgery, endovenous laser ablation (EVLA) (with phlebectomies) and UGFS on quality of life and the occlusion rate of the great saphenous vein (GSV) 12 months after surgery.

Methods: Patients with symptomatic, uncomplicated varicose veins (CEAP class C2-C4) were examined at baseline, 1 month and 1 year. Read More

Trials 2016 Aug 24;17(1):421. Epub 2016 Aug 24.

Academic Vascular Unit, Hull York Medical School, University of Hull, Hull, HU3 2JZ, UK.

Background: Endovenous thermal techniques, such as endovenous laser ablation (EVLA), are the recommended treatment for truncal varicose veins. However, a disadvantage of thermal techniques is that it requires the administration of tumescent anaesthesia, which can be uncomfortable. Non-thermal, non-tumescent techniques, such as mechanochemical ablation (MOCA) have potential benefits. Read More

Dermatol Surg 2016 Aug;42(8):961-6

*Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, California; †Division of Dermatology, University of Florida, Gainsville, Florida; ‡Scripps Clinic Department of Mohs Surgery, La Jolla, California; §Department of Dermatology, University of Texas San Antonio; ‖Scripps Clinic Vein Center, San Diego, California.

Background: Venous ulcers are very common with few curative treatment options.

Objective: To report the closure rate and clinical characteristics of active venous ulcers in a vein clinic using endovenous laser ablation (EVLA) with a 1,320-nm laser.

Methods And Materials: A prospective database was kept consisting of patients with an active venous ulcer at the time of consultation in a single-practitioner academic vein clinic from March 2007 to May 2014. Read More

Praxis (Bern 1994) 2016 Jul;105(14):813-9

2 Angiologie, Universitätsspital Basel.

Venous leg symptoms are frequent, but their relevance is frequently underestimated. With the introduction of effective, minimal-invasive endovenous treatment modalities the treatment of varicose veins has recently made major advances. The basis of every treatment decision is a competent anamnesis, clinical investigation and duplex scan. Read More

Wien Med Wochenschr 2016 Jun 13;166(9-10):297-301. Epub 2016 Jun 13.

VENEX - Zentrum für minimal invasive Venentherapie und ästhetische Dermatologie, Alser Strasse 47, 1080, Wien, Österreich.

In the past 15 years, the minimally invasive endovenous treatments of varicose veins have been widely accepted. The efficacy of the different endovenous methods and the minimal post operative side effects are meanwhile well documented in a large number of evidence based publications. The recent NICE Guidelines (2013) considering the varicose vein treatment recommend in case of an insufficiency of saphenous veins first the endovenous thermal ablation with radiofrequency or laser, then the ultrasound guided sclerotherapy and as the third line the classic surgical treatment with stripping and high ligation. Read More

Eur J Vasc Endovasc Surg 2016 Aug 1;52(2):242. Epub 2016 Jun 1.

Department of Vascular Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain. Electronic address:

Klin Khir 2016 Feb(2):48-51

Abstract The results of endovascular laser ablation (EVLA) under ultrasonographic control in treatment of the lower extremities varicose disease (LEVD) in 189 patients (214 extremities) were analyzed. There was established, that for the trustworthy information obtaining the ultrasonographic duplex angioscanning conduction is necessary. The fibrous involution of a big subcutaneous vein trunk was achieved in (97. Read More

Eur J Vasc Endovasc Surg 2016 Aug 25;52(2):268. Epub 2016 May 25.

Department of Vascular Surgery, University Hospital North Midlands, Stoke-on-Trent, UK. Electronic address:

Ther Adv Cardiovasc Dis 2016 Aug 19;10(4):251-5. Epub 2016 Apr 19.

Princess Alexandra Hospital, Harlow, Essex, UK.

Objectives: Tumescent local anaesthesia via multiple injections in the perivenous space leads to intraoperative and postoperative pain during endovenous laser ablation (EVLA). We considered whether the application of topical local anaesthesia reduces pain caused by these injections.

Methods: Eligible patients undergoing local anaesthetic EVLA were recruited and randomized to either application of topical local anaesthesia or water-based gel (placebo) to the inner thigh over the marked great saphenous vein. Read More

Acta Cir Bras 2016 Mar;31(3):161-7

Hospital Angelina Caron, Campina Grande do Sul, PR, Brazil.

Purpose: To develop an ex vivo model for the analysis of macroscopic, histological and immunohistochemical changes after experimental endovenous laser ablation (EVLA) of the great saphenous vein (GSV).

Methods: We describe a model produced with glass tubes and introducer sheaths to mimic the physiological conditions of EVLA procedures, such as tumescence and blood flow. A pilot study was conducted to evaluate an ex vivo procedure of EVLA of an incompetent GSV segment using a 1470-nm radial fiber diode laser (7 W power) and an automatic pull-back device. Read More

J Invest Surg 2016 Oct 24;29(5):254-9. Epub 2016 Mar 24.

a Department of Radiology , Wuxi Integrated Traditional Chinese and Western Medicine Hospital , Wuxi , China.

Background: Endovenous laser therapy (EVLT) is safe and effective for lower limb venous ulcers. However, severe necrosis and infection in the ulcer area are contraindications of puncture and EVLT. Local bath with ozone gas has been shown to improve the condition of ulcer areas. Read More

Phlebology 2017 May 7;32(4):272-281. Epub 2016 Mar 7.

3 Division of Vascular Surgery, Stony Brook School of Medicine, Stony Brook, NY, USA.

Objectives * Varithena 017 Investigator Group: Michael Vasquez, MD, Venous Institute of Buffalo, Amherst, NY; Antonios Gasparis, MD, Stony Brook University Medical Center, Stony Brook, NY; Kathleen Gibson, MD, Lake Washington Vascular, Bellevue, WA; James Theodore King, MD, Vein Clinics of America, Oakbrook Terrace, IL; Nick Morrison, MD, Morrison Vein Institute, Scottsdale, AZ; Girish Munavalli, MD, Dermatology, Laser & Vein Specialists of the Carolinas, Charlotte, NC; Eulogio J. Sanchez, MD, Batey Cardiovascular Center, Bradenton, FL. Varithena® is a trademark of Provensis Ltd, a BTG International group company. Read More

Langenbecks Arch Surg 2016 May 2;401(3):375-80. Epub 2016 Mar 2.

Heart and Vascular Center, University Hospital Hamburg-Eppendorf, Martinistaße 52, 20246, Hamburg, Germany.

Purpose: An estimated 350,000 varicose vein (VV) surgical procedures are performed in Germany each year, with annual treatment costs amounting to about 800 million Euro. To evaluate the outcome quality of this treatment, we examined the intraoperative and postoperative complication rates on record in the VV surgery quality assessment (QA) registry of the German Society for Vascular Surgery (GSVS).

Methods: Data on 89,647 patients (27,463 men, 62,184 women; average age 52. Read More

Phlebology 2016 Mar;31(1 Suppl):106-13

Department of Cardiovascular Surgery, Kayseri Research and Training Hospital, Kayseri, Turkey.

Introduction: Cyanoacrylate ablation is the newest nonthermal vein ablation technique. The one-year results of a prospective comparative study of a new cyanoacrylate glue versus endovenous laser ablation for the treatment of venous insufficiency is presented.

Material And Methods: A total of 310 adult subjects were treated with cyanoacrylate ablation or endovenous laser ablation. Read More

Phlebology 2016 Mar;31(1 Suppl):88-98

Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA

Objective: Relationships between duplex findings and data on health-related quality of life (QoL) to assess long-term results of treatment of varicose veins and chronic venous insufficiency (CVI) are not well known. The goal of this review was to correlate duplex findings and QoL assessments in clinical studies with long-term follow-up.

Methods: A review of the English language literature on PUBMED revealed 17 clinical studies, including 9 randomized controlled trials (RCTs), 6 prospective, and 2 retrospective studies that included patients with at least 5-year follow-up after endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), and traditional superficial venous surgery. Read More

Lasers Med Sci 2016 Apr 12;31(3):503-10. Epub 2016 Feb 12.

Ogarev Mordovia State University, 68 Bolshevistskaya Str., Saransk, 430005, Republic of Mordovia, Russia.

This paper presents the results of endovenous laser ablation (EVLA) of varicose veins in vitro using radiation of a solid-state laser based on the crystal LiYF4:Tm, with a wavelength of 1.885 μm and power output of around 3 W. An experimental series with saline solution and red blood cell (RBC) suspension in the venous lumen was performed to identify the impact of a heated carbonized layer precipitated on the fiber end face versus the efficiency of EVLA. Read More

Br J Surg 2016 Mar 25;103(4):374-81. Epub 2016 Jan 25.

School of Health Sciences, City University London, London, UK.

Background: The aim of this study was to assess behavioural recovery from the patient's perspective as a prespecified secondary outcome in a multicentre parallel-group randomized clinical trial comparing ultrasound-guided foam sclerotherapy (UGFS), endovenous laser ablation (EVLA) and surgery for the treatment of primary varicose veins.

Methods: Participants were recruited from 11 UK sites as part of the CLASS trial, a randomized trial of UGFS, EVLA or surgery for varicose veins. Patients were followed up 6 weeks after treatment and asked to complete the Behavioural Recovery After treatment for Varicose Veins (BRAVVO) questionnaire. Read More

Vasc Endovascular Surg 2016 Jan 14;50(1):47-51. Epub 2016 Jan 14.

Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

Purpose: To compare endovenous laser ablation (EVLA) and radiofrequency venous ablation (RFA) in different legs in the same patients with venous insufficiency.

Methods: Sixty patients with bilateral saphenous vein insufficiency were included. Endovenous laser ablation or RFA was applied to one of the patient's legs and the remaining procedure, RFA or EVLA, to the other leg. Read More

Int Heart J 2016 8;57(1):87-90. Epub 2016 Jan 8.

Kita-Aoyama D-Clinic Vein Center.

Endovenous laser ablation (EVLA), which is a relatively new therapeutic option for saphenous varicose veins of the legs, is less invasive than conventional stripping surgery with ligation. In this study, we evaluated the safety and effectiveness of EVLA combined with ligation for severe saphenous varicose veins that were graded as ≥ C4 by the CEAP classification. We treated 119 Japanese patients (141 limbs) between July 2005 and December 2007 utilizing a 1320-nm Nd:YAG laser. Read More

Int J Technol Assess Health Care 2015 Jan 30;31(5):289-96. Epub 2015 Dec 30.

Academic Section of Vascular Surgery,Imperial College School of Medicine,Charing Cross Hospital.

Objectives: Although the clinical benefits of endovenous thermal ablation are widely recognized, few studies have evaluated the health economic implications of different treatments. This study compares 6-month clinical outcomes and cost-effectiveness of endovenous laser ablation (EVLA) compared with radiofrequency ablation (RFA) in the setting of a randomized clinical trial.

Methods: Patients with symptomatic primary varicose veins were randomized to EVLA or RFA and followed up for 6 months to evaluate clinical improvements, health related quality of life (HRQOL) and cost-effectiveness. Read More

Surg Today 2016 Sep 21;46(9):1019-23. Epub 2015 Dec 21.

Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.

Purpose: This study was designed to analyze the efficacy and complications in endovenous LASER ablation (EVLA) with 1470 nm diode lasers using low linear endovenous energy density (LEED) combined with high ligation for varicose veins of the great saphenous vein (GSV).

Methods: One hundred and sixteen limbs of 102 patients were analyzed using 6 W with 2 mm/s constant pullback speed delivered by 30 J/cm LEED. The SFJ was ligated with a small inguinal incision. Read More

Phlebology 2017 Feb 9;32(1):13-18. Epub 2016 Jul 9.

1 Clinical Surgery, Universidade Federal do Paraná, Curitiba, Brazil.

Objectives To determine great saphenous vein occlusion rate after endovenous laser ablation using the 1470-nm bare-fiber diode laser to supply either 7 W or 15 W and evaluate procedure-related complications. Method Patients with varicose veins of the lower extremities (CEAP class C2-C6) were randomly assigned to undergo either 7-W (18 patients, 30 limbs) or 15-W (18 patients, 30 limbs) endovenous laser ablation. Duplex ultrasound follow-up was at 3-5 days, 1, 6, and 12 months postoperatively. Read More

J Vasc Surg 2016 Feb 23;63(2):420-8. Epub 2015 Oct 23.

Centrum Oosterwal, Alkmaar, The Netherlands.

Objective: The objective of this study was to compare the long-term results (groin-related recurrence, great saphenous vein [GSV] occlusion rate, Clinical class, Etiology, Anatomy, and Pathophysiology [CEAP] staging, and quality of life [QoL]) after the treatment of a GSV incompetence by saphenofemoral ligation and stripping (SFL/S) with endovenous laser ablation bare fiber, 980 nm (EVLA).

Methods: Patients with GSV insufficiency and varicose veins were randomized to either undergo SFL/S or EVLA, both of which were performed under tumescent anesthesia. The long-term results, which included the anatomic occlusion rate, varicose vein recurrence at the saphenofemoral junction (SFJ), relief of venous symptoms and QoL, were compared up to 5 years after treatment. Read More

Diagn Interv Radiol 2016 Jan-Feb;22(1):59-64

Department of Radiology, Maltepe University School of Medicine, Istanbul, Turkey.

Purpose: We aimed to investigate the feasibility and safety of the endovenous ambulatory selective varicose vein ablation under local anesthesia (eASVAL) method in a selected group of pa-tients with varicose disease and present the short-term results of one-year ultrasonographic follow-up.

Methods: Three hundred and ninety-five consecutive patients with varicose veins who had been treated with endovenous laser ablation (EVLA) were retrospectively reviewed over a period of two years. From this group, 41 patients who were treated using the eASVAL technique and had the great saphenous vein (GSV) preserved were included in the study. Read More

J Endovasc Ther 2016 Feb 12;23(1):199-211. Epub 2015 Nov 12.

Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands.

Purpose: To investigate and compare the anatomical success rates and complications of the treatment modalities for small saphenous vein (SSV) incompetence.

Methods: A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library on the following therapies for incompetence of SSVs: surgery, endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), steam ablation, and mechanochemical endovenous ablation (MOCA). The search found 49 articles (5 randomized controlled trials, 44 cohort studies) reporting on the different treatment modalities: surgery (n=9), EVLA (n=28), RFA (n=9), UGFS (n=6), and MOCA (n=1). Read More

Phlebology 2015 Nov;30(2 Suppl):36-41

Academic Vascular Surgical Unit, University of Hull, UK

Laser ablation involves the delivery of laser light through a glass fibre placed into the lumen of a refluxing vein. This energy is converted into heat inducing a permanent, non-thrombotic occlusion. This highly effective and safe approach has significant advantages over traditional surgical treatment and has driven the endovenous revolution in the management of varicose veins. Read More

Phlebology 2015 Nov;30(2 Suppl):29-35

Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK

Despite recent NICE guidance there remains a definite role for surgery in the management of varicose veins. A lot of the available evidence that has driven the transformation of care towards endovenous treatments is of good quality yet published by enthusiasts. No endovenous studies have reported long term results as far out from intervention as the open studies, yet in the meta-analysis from Murad et al, the authors suggested from their results that when surgery was compared with all endoluminal ablation therapies, surgery was associated with a non-significant reduction in the risk of varicose vein recurrence (RR0. Read More

Phlebology 2015 Nov;30(2 Suppl):24-8

The Whiteley Clinic, Guildford and London, UK

In July 2013, the National Institute of Health and Clinical Excellence (NICE) recommended "endothermal" ablation (meaning endovenous thermal ablation) is the first line treatment for truncal venous reflux in varicose veins. The initial endovenous thermoablation devices were radiofrequency ablation and endovenous laser ablation. More recently, Glue (cyanoacrylate), endovenous steam and Clarivein (mechanochemical ablation or MOCA) have entered the market as new endovenous techniques for the treatment of varicose veins. Read More

Phlebology 2015 Nov;30(2 Suppl):18-23

Freeman Hospital, Newcastle upon Tyne, UK.

Foam sclerotherapy is a minimally invasive treatment for lower limb varicose veins. Current evidence indicates that its efficacy may not be as high as surgery or endovenous ablation. The minimally invasive nature of the treatment however means that it has a wide application, and it can be particularly useful in patients who are not suitable for other types of treatment. Read More