Endovenöse Laserablation vs. Crossektomie und Stripping-Operation

  • \(\bf Objective:\) The long-term results of saphenofemoral ligation and stripping (SFL/S) were compared with 980-nm bare fiber endovenous laser ablation (EVLA) for the treatment of great saphenous vein (GSV) incompetence. \(\bf Methods:\) This was a single-center, randomized, controlled trial with a follow-up time of 10 years. Patients with GSV incompetence were randomized to undergo SFL/S or EVLA under tumescent anesthesia. The primary outcome was recurrence of groin-related varicose veins seen on duplex ultrasound imaging and clinical examination. The secondary outcomes were (changes or improvement in) CEAP clinical class, venous symptoms, cosmetic results, quality of life, reinterventions, and complications. \(\bf Results:\) Between June 2007 and December 2008, 122 patients (130 limbs) were included; of these, 68 limbs were treated with SFL/S and 62 limbs with EVLA. The 10-year estimated freedom from groin recurrence as seen on duplex ultrasound imaging was higher in the SFL/S group (73% vs 44% in the EVLA group; P = .002), and the same trend was seen for clinically evident recurrence (77% vs 58%, respectively; P = .034). Nine reinterventions (17%) were deemed necessary in the SFL/S group vs 18 (36%) in the EVLA group (P = .059). All reinterventions in the SFL/S group consisted of foam sclerotherapy. Reinterventions in the EVLA group included foam sclerotherapy (n = 5), crossectomy (n = 2), and endovenous procedures (n = 11). There was no significant differences in quality of life and relief of venous symptoms. Cosmetic appearance improved, with a better cosmetic rating in the SFL/S group compared with the EVLA group (P = .026). One patient in the SFL/S group had a persisting neurosensory deficit remaining at 10 years. \(\bf Conclusions:\) This study showed no clear long-term advantage of EVLA with a 980-nm wavelength and bare-tip fiber over high ligation and stripping of the GSV under local tumescent anesthesia.

Download full text files

Export metadata

Additional Services

Share in Twitter Search Google Scholar
Author:Markus StückerGND
Parent Title (German):Kompass Dermatologie
Subtitle (German):Welche Methode gewinnt im 10-Jahres-Vergleich?
Place of publication:Basel
Document Type:Article
Date of Publication (online):2024/04/19
Date of first Publication:2023/03/14
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Endovenous laser ablation; Great saphenous vein insufficiency; High ligation and stripping; Tumescent anesthesia; Varicose veins; Vein insufficiency
First Page:25
Last Page:26
Dieser Beitrag ist aufgrund einer konsortialen Lizenz frei zugänglich.
Institutes/Facilities:St. Josef-Hospital Bochum, Klinik für Dermatologie, Venerologie und Allergologie
Dewey Decimal Classification:Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit
open_access (DINI-Set):open_access
Licence (German):License LogoKonsortiale Lizenz