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Title: Outcome of endovenous laser therapy for saphenous reflux and varicose veins: medium-term results assessed by ultrasound surveillance.
Epworth Authors: Myers, Ken
Other Authors: Jolley, Damien
Keywords: Varicose Veins
Venous Insufficiency
Saphenous Veins
Saphenous Reflux
Endovenous Laser Therapy
Laser Treatment
Ultrasound-Guided Sclerotherapy
Multivariate Cox Regression Analysis
UroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Feb-2009
Publisher: Elsevier
Citation: Eur J Vasc Endovasc Surg. 2009 Feb;37(2):239-45.
Abstract: OBJECTIVE: To assess the efficacy of endovenous laser therapy (EVLT) for treating saphenous reflux associated with varicose veins. DESIGN: Out-patient treatment by EVLT with an 810nm laser wavelength with results assessed by ultrasound surveillance. PATIENTS: 361 patients who received EVLT for 509 incompetent saphenous veins over a five-year period. METHODS: EVLT was used for proximal saphenous veins and ultrasound-guided sclerotherapy (UGS) for distal saphenous veins and tributaries. Control of reflux and occlusion or obliteration of the saphenous veins was assessed by serial ultrasound studies. Univariate Kaplan-Meier life table analysis showed cumulative primary and secondary success rates, and multivariate Cox regression analysis assessed covariates that could be associated with increased risk of ultrasound failure. RESULTS: Life table analysis showed primary success at four years in 76% (95% CI 56-87%) and secondary success at four years after further treatment of recurrence by UGS in 97% (95% CI 93-99%). Cox regression analysis showed a non-significant trend towards worse primary success in male patients and worse results for older patients and limbs with clinical CEAP categories C4-6. Cox regression showed significantly worse secondary success for limbs with clinical CEAP C4-6. CONCLUSIONS: EVLT effectively controls saphenous reflux particularly with ultrasound surveillance to detect early recurrence that can be treated by UGS. Modifications in technique may be required to improve the late primary success rate.
DOI: 10.1016/j.ejvs.2008.09.009
PubMed URL:
ISSN: 1078-5884
Journal Title: European Journal of Vascular and Endovascular Surgery
Type: Journal Article
Affiliated Organisations: Monash Institute of Health Services Research, Melbourne, Australia
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Diagnostic Services
UroRenal, Vascular

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