Endovascular Laser Ablation for Varicose Veins with Dilated Saphenofemoral Junction

Abstract

Endovenous laser ablation (EVLA) for varicose veins with dilated saphenofemoral junction (SFJ) is controversial. EVLA using 980 nm diode laser was performed on 215 legs in patients with great saphenous vein insufficiency. They were divided into two groups; group L with SFJ 10–20 mm, group S with SFJ <10 mm. The follow-up results using duplex ultrasound were compared between the groups. The median follow-up period was 12 months in both groups. Laser power (9.6±0.6 W vs 9.2±0.6 W, p<0.001) and linear endovenous energy density (79±8 J/cm vs 75±9 J/cm, p<0.001) were significantly greater in group L. The incidence of endovenous heat-induced thrombosis (class 0: 87% vs 89%, p=0.642), the rate of recanalization (1% vs 1%, p=0.999) or reoperation (1% vs 0%, p=0.999) were similar in both groups. In 6 legs with SFJ>15 mm, the SFJ diameter (16.5±1.5 mm) significantly (p<0.001) decreased to less than 10 mm (6.5±0.8 mm) postoperatively. EVLA without concomitant high ligation for dilated SFJ (<20 mm) is feasible with relatively high energy ablation.