Venoarterial Flow Index Steadily Improves After Endovenous Laser Treatment of the Great Saphenous Vein

BACKGROUND Endovenous laser treatment (EVLT) is a minimally invasive procedure to ablate varicose veins. The venous arterial flow index (VAFI) represents a quantitative duplex ultrasound parameter to characterize venous hemodynamics, which has not been investigated in EVLT so far. OBJECTIVE To analyze the hemodynamic improvement of EVLT of the great saphenous vein (GSV) according to VAFI measurement. MATERIALS AND METHODS One hundred thirty-three participants with complete GSV insufficiency were treated with 810-nm EVLT. VAFI as a ratio of venous and arterial flow volumes of the common femoral vessels and digital photoplethysmography (DPPG) were assessed before and 3 (n=129) and 12 months (n=71) after EVLT. RESULTS EVLT was performed with an energy fluence of 22.5 J/cm2, resulting in an occlusion rate of 98.4%. Duplex recurrence rates were 9.4% at 3-month and 15.5% at 12-month follow-up. VAFI significantly improved from 1.395 to 1.242 and 1.167 (p <.001) 3 and 12 months after EVLT. Venous refilling time (DPPG) accordingly increased from 20.0 to 36.9 seconds (p <.001) 3 months postoperatively. CONCLUSION EVLT improves hemodynamic alterations in people with incompetent GSVs as demonstrated using VAFI and DPPG. VAFI might be a suitable diagnostic tool to quantify venous hemodynamics in people with varicose veins. The authors have indicated no significant interest with commercial supporters.