Randomised Controlled Trial Comparing Sapheno-Femoral Ligation and Stripping of the Great Saphenous Vein With Endovenous Laser Ablation (980 Nm) Using Local Tumescent Anaesthesia: One Year Results

Eur J Vasc Endovasc Surg. 2010 Nov;40(5):649-56. doi: 10.1016/j.ejvs.2010.08.007.

Abstract

Objectives: Comparison of sapheno-femoral ligation and stripping (SFL/S) versus endovenous laser ablation (EVLA, 980-nm) in the treatment of great saphenous vein (GSV) insufficiency, using local tumescent anaesthesia.

Design: Randomised, single centre trial.

Materials and methods: Patients with GSV incompetence and varicose veins were randomised to either SFL/S or EVLA. At days 1, 2, 3, 7, 10, and 14 post-treatment, patients completed questionnaires on pain and quality of life. Recurrent varicose veins were evaluated by Duplex ultrasound (DUS) performed at 1 and 6 weeks, and 6 and 12 months.

Results: 130 legs in 121 patients were treated by SFL/S (n=68) or EVLA (n=62). Significantly more post-treatment pain was noted after EVLA at days 7, 10 and 14 (p<0.01; p<0.01; p=0.01), more hindrance in mobility at days 7 (p<0.01) and 10 (p=0.01), and in self care (p=0.03) and daily activities (p=0.01) at day 7 compared to SFL/S. DUS at 1-year follow-up showed 9% recurrences (5/56) after EVLA and 10% (5/49) after SFL/S.

Conclusion: Both SFL/S and EVLA, using local tumescent anaesthesia, were well tolerated, with no difference in short-term recurrence rate. In the second week after EVLA, patients experienced significantly more pain resulting in restricted mobility, self care and daily activity compared to SFL/S.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthesia, Local
  • Female
  • Femoral Vein / surgery*
  • Follow-Up Studies
  • Humans
  • Laser Therapy*
  • Ligation
  • Male
  • Middle Aged
  • Prospective Studies
  • Saphenous Vein / surgery*
  • Varicose Veins / surgery*
  • Vascular Surgical Procedures
  • Venous Insufficiency / surgery*