Treatment of varicose veins by endovenous laser therapy: assessment of results by ultrasound surveillance.

Abstract

OBJECTIVE: To assess the efficacy of endovenous laser therapy (EVLT) for treating varicose veins with saphenous reflux. DESIGN: A trial of treatment, with results assessed by ultrasound surveillance. SETTING: Outpatient clinics with sonographer and nursing support. MAIN OUTCOME MEASURES: Control of reflux; occlusion or obliteration of the saphenous veins assessed by ultrasound. RESULTS: EVLT was used to treat 404 veins in 308 patients. Univariate life table analysis showed primary success in 80% (95% CI, 69%-87%) and secondary success after further treatment of recurrent saphenous vein reflux by ultrasound-guided sclerotherapy in 88% (95% CI, 78%-95%) at 3 years. On multivariate Cox regression analysis, none of the covariates studied were associated with ultrasound failure. CONCLUSIONS: Early results indicate that EVLT effectively controlled saphenous reflux. Its advantages are that it is performed as an outpatient procedure under local anaesthesia with immediate mobilisation, causes minimal disruption of activities, and avoids surgical trauma.