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Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia.
J Vasc Surg. 2016 Feb; 63(2):420-8.JV

Abstract

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.

RESULTS

A total of 130 legs of 121 patients were treated with either SFL/S (n = 68) or EVLA (n = 62). In the first 12 months, three recanalizations of the GSV were observed after EVLA. Up to 5 years later, more recurrent varicose veins caused by neoreflux in incompetent tributaries of the SFJ were observed in after EVLA (31%; 19/61) compared with SFL/S (7%; 4/60; P < .01). Neovascularization in the groin with clinically visible recurrence identified at 3 and 5 years post-treatment follow-up was only observed in the SFL/S group (n = 6). After 5 years, clinically visible recurrences originating from the SFJ region after EVLA were observed 33% (20/61) compared with 17% of patients (10/60) after SFL/S (P < .04). In both treatment groups, venous symptoms improved significantly. Patients in both groups reported a continuing significant cosmetic improvement measured on a visual analog scale of 1 to 10 (mean, 7.49; P < .01). There was no difference in the CEAP staging and a standardized, non-disease-specific instrument for describing and valuing health states (EuroQol-5D), between the groups up to 5 years after follow-up.

CONCLUSIONS

At the 5-year follow-up, a significantly higher varicose vein recurrence rate originated at the SFJ region after EVLA compared with SFL/S. There were no differences in the relief of venous symptoms, CEAP staging, or general QoL between the groups.

Authors+Show Affiliations

Centrum Oosterwal, Alkmaar, The Netherlands. Electronic address: s.gauw@centrum-oosterwal.nl.Centrum Oosterwal, Alkmaar, The Netherlands.Centrum Oosterwal, Alkmaar, The Netherlands.Centrum Oosterwal, Alkmaar, The Netherlands.Centrum Oosterwal, Alkmaar, The Netherlands.Centrum Oosterwal, Alkmaar, The Netherlands.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26602795

Citation

Gauw, Stefanie A., et al. "Five-year Follow-up of a Randomized, Controlled Trial Comparing Saphenofemoral Ligation and Stripping of the Great Saphenous Vein With Endovenous Laser Ablation (980 Nm) Using Local Tumescent Anesthesia." Journal of Vascular Surgery, vol. 63, no. 2, 2016, pp. 420-8.
Gauw SA, Lawson JA, van Vlijmen-van Keulen CJ, et al. Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia. J Vasc Surg. 2016;63(2):420-8.
Gauw, S. A., Lawson, J. A., van Vlijmen-van Keulen, C. J., Pronk, P., Gaastra, M. T., & Mooij, M. C. (2016). Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia. Journal of Vascular Surgery, 63(2), 420-8. https://doi.org/10.1016/j.jvs.2015.08.084
Gauw SA, et al. Five-year Follow-up of a Randomized, Controlled Trial Comparing Saphenofemoral Ligation and Stripping of the Great Saphenous Vein With Endovenous Laser Ablation (980 Nm) Using Local Tumescent Anesthesia. J Vasc Surg. 2016;63(2):420-8. PubMed PMID: 26602795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia. AU - Gauw,Stefanie A, AU - Lawson,James A, AU - van Vlijmen-van Keulen,Clarissa J, AU - Pronk,Pascal, AU - Gaastra,Menno T W, AU - Mooij,Michael C, Y1 - 2015/10/23/ PY - 2015/02/19/received PY - 2015/08/17/accepted PY - 2015/11/26/entrez PY - 2015/11/26/pubmed PY - 2016/6/9/medline SP - 420 EP - 8 JF - Journal of vascular surgery JO - J Vasc Surg VL - 63 IS - 2 N2 - 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. RESULTS: A total of 130 legs of 121 patients were treated with either SFL/S (n = 68) or EVLA (n = 62). In the first 12 months, three recanalizations of the GSV were observed after EVLA. Up to 5 years later, more recurrent varicose veins caused by neoreflux in incompetent tributaries of the SFJ were observed in after EVLA (31%; 19/61) compared with SFL/S (7%; 4/60; P < .01). Neovascularization in the groin with clinically visible recurrence identified at 3 and 5 years post-treatment follow-up was only observed in the SFL/S group (n = 6). After 5 years, clinically visible recurrences originating from the SFJ region after EVLA were observed 33% (20/61) compared with 17% of patients (10/60) after SFL/S (P < .04). In both treatment groups, venous symptoms improved significantly. Patients in both groups reported a continuing significant cosmetic improvement measured on a visual analog scale of 1 to 10 (mean, 7.49; P < .01). There was no difference in the CEAP staging and a standardized, non-disease-specific instrument for describing and valuing health states (EuroQol-5D), between the groups up to 5 years after follow-up. CONCLUSIONS: At the 5-year follow-up, a significantly higher varicose vein recurrence rate originated at the SFJ region after EVLA compared with SFL/S. There were no differences in the relief of venous symptoms, CEAP staging, or general QoL between the groups. SN - 1097-6809 UR - https://www.unboundmedicine.com/medline/citation/26602795/Five_year_follow_up_of_a_randomized_controlled_trial_comparing_saphenofemoral_ligation_and_stripping_of_the_great_saphenous_vein_with_endovenous_laser_ablation__980_nm__using_local_tumescent_anesthesia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(15)01834-0 DB - PRIME DP - Unbound Medicine ER -