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Randomized clinical trial comparing endovenous laser ablation of the great Saphenous vein with and without ligation of the sapheno-femoral junction: 2-year results.
Eur J Vasc Endovasc Surg. 2008 Dec; 36(6):713-8.EJ

Abstract

OBJECTIVE

To evaluate whether ligation of the sapheno-femoral junction (SFJ) improves the 2-year results of endovenous laser ablation (EVA).

METHODS

Forty-three symptomatic patients with bilateral varicose veins were studied in which one limb was randomly assigned to receive EVA without SFJ ligation, and the other limb received EVA with SFJ ligation. Recurrence of varicose veins and abolition of great saphenous vein (GSV) reflux on duplex ultrasound imaging, and venous clinical severity score (VCSS) were investigated at 6, 12, and 24 months after treatment.

RESULTS

Two-year life table analysis showed freedom from groin varicose vein recurrence in 83% of 43 limbs (95% CI; 67-95%) in the EVA without ligation group and in 87% of 43 limbs (95%; CI 73-97) of limbs in the EVA with ligation group (P=0.47). Thirty-eight (88%) treated GSV segments were ablated completely in the EVA without ligation group and 42 (98%) in the EVA with ligation group (N.S.). Groin recurrence was due to an incompetent SFJ/GSV (9%) and to incompetent tributaries (7%) in the EVA without ligation group and due to neovascularisation (12%) in the EVA with ligation group. The VCSS improved significantly and was comparable in both groups.

CONCLUSION

The addition of SFJ ligation to EVA makes no difference to the short-term outcome of varicose veins treatment. Establishing whether SFJ ligation results in a poorer long-term outcome because of neovascularisation needs to be studied in larger populations with longer follow-up.

Authors+Show Affiliations

Department of Surgery, Mesos Medical Centre, Van Heuven, Goedhartlaan 1, 3527 CE, Utrecht, The Netherlands. disselhoff@planet.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18848791

Citation

Disselhoff, B C V M., et al. "Randomized Clinical Trial Comparing Endovenous Laser Ablation of the Great Saphenous Vein With and Without Ligation of the Sapheno-femoral Junction: 2-year Results." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 36, no. 6, 2008, pp. 713-8.
Disselhoff BC, der Kinderen DJ, Kelder JC, et al. Randomized clinical trial comparing endovenous laser ablation of the great Saphenous vein with and without ligation of the sapheno-femoral junction: 2-year results. Eur J Vasc Endovasc Surg. 2008;36(6):713-8.
Disselhoff, B. C., der Kinderen, D. J., Kelder, J. C., & Moll, F. L. (2008). Randomized clinical trial comparing endovenous laser ablation of the great Saphenous vein with and without ligation of the sapheno-femoral junction: 2-year results. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 36(6), 713-8. https://doi.org/10.1016/j.ejvs.2008.08.015
Disselhoff BC, et al. Randomized Clinical Trial Comparing Endovenous Laser Ablation of the Great Saphenous Vein With and Without Ligation of the Sapheno-femoral Junction: 2-year Results. Eur J Vasc Endovasc Surg. 2008;36(6):713-8. PubMed PMID: 18848791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized clinical trial comparing endovenous laser ablation of the great Saphenous vein with and without ligation of the sapheno-femoral junction: 2-year results. AU - Disselhoff,B C V M, AU - der Kinderen,D J, AU - Kelder,J C, AU - Moll,F L, Y1 - 2008/10/10/ PY - 2008/01/17/received PY - 2008/08/10/accepted PY - 2008/10/14/pubmed PY - 2008/12/19/medline PY - 2008/10/14/entrez SP - 713 EP - 8 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JO - Eur J Vasc Endovasc Surg VL - 36 IS - 6 N2 - OBJECTIVE: To evaluate whether ligation of the sapheno-femoral junction (SFJ) improves the 2-year results of endovenous laser ablation (EVA). METHODS: Forty-three symptomatic patients with bilateral varicose veins were studied in which one limb was randomly assigned to receive EVA without SFJ ligation, and the other limb received EVA with SFJ ligation. Recurrence of varicose veins and abolition of great saphenous vein (GSV) reflux on duplex ultrasound imaging, and venous clinical severity score (VCSS) were investigated at 6, 12, and 24 months after treatment. RESULTS: Two-year life table analysis showed freedom from groin varicose vein recurrence in 83% of 43 limbs (95% CI; 67-95%) in the EVA without ligation group and in 87% of 43 limbs (95%; CI 73-97) of limbs in the EVA with ligation group (P=0.47). Thirty-eight (88%) treated GSV segments were ablated completely in the EVA without ligation group and 42 (98%) in the EVA with ligation group (N.S.). Groin recurrence was due to an incompetent SFJ/GSV (9%) and to incompetent tributaries (7%) in the EVA without ligation group and due to neovascularisation (12%) in the EVA with ligation group. The VCSS improved significantly and was comparable in both groups. CONCLUSION: The addition of SFJ ligation to EVA makes no difference to the short-term outcome of varicose veins treatment. Establishing whether SFJ ligation results in a poorer long-term outcome because of neovascularisation needs to be studied in larger populations with longer follow-up. SN - 1532-2165 UR - https://www.unboundmedicine.com/medline/citation/18848791/Randomized_clinical_trial_comparing_endovenous_laser_ablation_of_the_great_Saphenous_vein_with_and_without_ligation_of_the_sapheno_femoral_junction:_2_year_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(08)00464-4 DB - PRIME DP - Unbound Medicine ER -