Comparative effectiveness of endovenous laser coagulation techniques in preventing recurrences of varicose vein disease in the lower extremities

Introduction. In recent years, endovenous laser coagulation (EVLC) has become the primary method for treating varicose vein disease of the lower extremities. However, the long-term clinical outcomes of EVLC are similar to those of classical surgical interventions, while the anatomical causes of recurrence identified through duplex scanning differ.

Aim. To compare the recurrence rates of varicose vein disease after isolated EVLC of the great saphenous vein (GSV) and a combined procedure that includes the anterior accessory vein (AASV) in the long-term postoperative period.

Materials and methods. A comparative study was conducted involving 162 individuals with varicose veins in the legs. All participants underwent EVLC of the GSV. The patients were divided into two groups: Group I consisted of 81 individuals who underwent isolated EVLC of the GSV; Group II included 81 individuals who underwent combined EVLC of the GSV and AASV.

Results. Early postoperative complications revealed no statistically significant differences between the groups. According to the results of follow-up ultrasound duplex scanning performed three years after the surgery in Group I (EVLC of GSV), the reflux rate in the thigh area was statistically significantly higher at 15 (18.5%) compared to Group II 1 (1.2%) (EVLC of GSV + AA SV). This difference was statistically significant (p < 0.05).

Discussion. The studies show that preventive EVLC of the AASV significantly reduces the recurrence rates of varicose vein disease by 25%.

Conclusions. Obliteration of the AASV, regardless of the presence of reflux and their size, is a justified strategy for reducing the number of recurrences in the long-term postoperative period.

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