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Endovenous laser ablation (EVLA) of the anterior accessory great saphenous vein (AAGSV): abolition of sapheno-femoral reflux with preservation of the great saphenous vein.
Eur J Vasc Endovasc Surg. 2009 Apr; 37(4):477-81.EJ

Abstract

AIM

During surgery for sapheno-femoral junction (SFJ) and anterior accessory great saphenous vein (AAGSV) reflux, many surgeons also strip the great saphenous vein (GSV). This study assesses the short-term efficacy (abolition of reflux on Duplex ultrasound) of endovenous laser ablation (EVLA) of the AAGSV with preservation of a competent GSV in the treatment of varicose veins occurring due to isolated AAGSV incompetence.

METHOD

Thirty-three patients (21 women and 12 men) undergoing AAGSV EVLA alone (group A) and 33 age/sex-matched controls undergoing GSV EVLA (Group B) were studied. Comparisons included ultrasound assessment of SFJ competence, successful axial vein ablation, Aberdeen Varicose Vein Symptom Severity Scores (AVVSS) and a visual analogue patient-satisfaction scale.

RESULTS

At the 1-year follow-up, EVLA had successfully abolished the target vein reflux (AAGSV: median length 19 cm (inter-quartile range, IQR: 14-24 cm) vs. GSV: 32 cm (IQR 24-42 cm)) and had restored SFJ competence in all patients. Twenty of the 33 patients (61%) in group A and 14 of the 33 (42%) in group B (p=0.218) required post-ablation sclerotherapy at 6 weeks post-procedure for residual varicosities. The AVVSS at 12 months follow-up had improved from the pre-treatment scores in both the groups (group A: median score 4.1 (IQR 2.1-5.2) vs. 11.6 (IQR: 6.9-15.1) p<0.001; group B: median score 3.3 (IQR 1.1-4.5) vs. 14.5 (IQR 7.6-20.2), p<0.001), with no significant difference between the groups. Patient-satisfaction scores were similar (group A: 84% and group B: 90%). Previous intervention in group A included GSV EVLA (n=3) or stripping (n=9). Thus, the GSV was preserved in 21 patients. The AVVSS also improved in this subgroup (4.4 (2.0-5.4) vs. 11.4 (6.0-14.1), p<0.001) and SFJ/GSV competence was found to be restored at the 1-year follow-up.

CONCLUSIONS

AAGSV EVLA abolishes SFJ reflux, improves symptom scores and is, therefore, suitable for treating varicose veins associated with AAGSV reflux.

Authors+Show Affiliations

Leeds Vascular Institute, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19201621

Citation

Theivacumar, N S., et al. "Endovenous Laser Ablation (EVLA) of the Anterior Accessory Great Saphenous Vein (AAGSV): Abolition of Sapheno-femoral Reflux With Preservation of the Great Saphenous Vein." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 37, no. 4, 2009, pp. 477-81.
Theivacumar NS, Darwood RJ, Gough MJ. Endovenous laser ablation (EVLA) of the anterior accessory great saphenous vein (AAGSV): abolition of sapheno-femoral reflux with preservation of the great saphenous vein. Eur J Vasc Endovasc Surg. 2009;37(4):477-81.
Theivacumar, N. S., Darwood, R. J., & Gough, M. J. (2009). Endovenous laser ablation (EVLA) of the anterior accessory great saphenous vein (AAGSV): abolition of sapheno-femoral reflux with preservation of the great saphenous vein. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 37(4), 477-81. https://doi.org/10.1016/j.ejvs.2008.11.035
Theivacumar NS, Darwood RJ, Gough MJ. Endovenous Laser Ablation (EVLA) of the Anterior Accessory Great Saphenous Vein (AAGSV): Abolition of Sapheno-femoral Reflux With Preservation of the Great Saphenous Vein. Eur J Vasc Endovasc Surg. 2009;37(4):477-81. PubMed PMID: 19201621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endovenous laser ablation (EVLA) of the anterior accessory great saphenous vein (AAGSV): abolition of sapheno-femoral reflux with preservation of the great saphenous vein. AU - Theivacumar,N S, AU - Darwood,R J, AU - Gough,M J, Y1 - 2009/02/07/ PY - 2008/07/13/received PY - 2008/11/18/accepted PY - 2009/2/10/entrez PY - 2009/2/10/pubmed PY - 2009/4/1/medline SP - 477 EP - 81 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 - 37 IS - 4 N2 - AIM: During surgery for sapheno-femoral junction (SFJ) and anterior accessory great saphenous vein (AAGSV) reflux, many surgeons also strip the great saphenous vein (GSV). This study assesses the short-term efficacy (abolition of reflux on Duplex ultrasound) of endovenous laser ablation (EVLA) of the AAGSV with preservation of a competent GSV in the treatment of varicose veins occurring due to isolated AAGSV incompetence. METHOD: Thirty-three patients (21 women and 12 men) undergoing AAGSV EVLA alone (group A) and 33 age/sex-matched controls undergoing GSV EVLA (Group B) were studied. Comparisons included ultrasound assessment of SFJ competence, successful axial vein ablation, Aberdeen Varicose Vein Symptom Severity Scores (AVVSS) and a visual analogue patient-satisfaction scale. RESULTS: At the 1-year follow-up, EVLA had successfully abolished the target vein reflux (AAGSV: median length 19 cm (inter-quartile range, IQR: 14-24 cm) vs. GSV: 32 cm (IQR 24-42 cm)) and had restored SFJ competence in all patients. Twenty of the 33 patients (61%) in group A and 14 of the 33 (42%) in group B (p=0.218) required post-ablation sclerotherapy at 6 weeks post-procedure for residual varicosities. The AVVSS at 12 months follow-up had improved from the pre-treatment scores in both the groups (group A: median score 4.1 (IQR 2.1-5.2) vs. 11.6 (IQR: 6.9-15.1) p<0.001; group B: median score 3.3 (IQR 1.1-4.5) vs. 14.5 (IQR 7.6-20.2), p<0.001), with no significant difference between the groups. Patient-satisfaction scores were similar (group A: 84% and group B: 90%). Previous intervention in group A included GSV EVLA (n=3) or stripping (n=9). Thus, the GSV was preserved in 21 patients. The AVVSS also improved in this subgroup (4.4 (2.0-5.4) vs. 11.4 (6.0-14.1), p<0.001) and SFJ/GSV competence was found to be restored at the 1-year follow-up. CONCLUSIONS: AAGSV EVLA abolishes SFJ reflux, improves symptom scores and is, therefore, suitable for treating varicose veins associated with AAGSV reflux. SN - 1532-2165 UR - https://www.unboundmedicine.com/medline/citation/19201621/Endovenous_laser_ablation__EVLA__of_the_anterior_accessory_great_saphenous_vein__AAGSV_:_abolition_of_sapheno_femoral_reflux_with_preservation_of_the_great_saphenous_vein_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(08)00654-0 DB - PRIME DP - Unbound Medicine ER -