A novel endovenous laser ablation strategy of treatment of greater saphenous vein varicosities with difficult wire placement

Aim: To investigate the efficacy and early postoperative morbidity of a novel endovenous laser ablation (IEVLA) strategy of treatment of the great saphenous vein (GSV) with difficulty of wire placement. Methods: Sixty patients with serious GSV incompetence in 73 limbs were randomized into two treatment groups: Group 1 underwent traditional endovenous laser ablation (TEVLA) surgery and group 2 received IEVLA. Local pain, ecchymosis, induration, paraesthesia in treated regions, thrombotic diseases, vein diameter, treated vein length, delivered energy, operation duration, success rate in placement of the laser fiber and venous clinical severity (VCS) scores were recorded for both group. Follow-up were conducted on the 2nd day, 7th day, and 1st, 2nd, 3rd and 6th month postoperatively. Results: In group 1, induration was present in 18 cases, ecchymosis in 19, paraesthesia in 9, pulmonary embolism (PE) in 1 case, and deep vein thrombus (DVT) in 3. While in group 2, induration present in 29, ecchymosis in 23, paraesthesia in 17 with and no patients were complicated with PE or DVT. Although no difference in improvement of VCS score existed between the two groups at each follow-up time point, group 2 had significantly shorter operation time and higher success rate (P < 0.05). Conclusion: IEVLA is a more effective and safe technique for treatment of serious GSV varicosities with difficulty of wire placement.