1,2Samir Abou Zied

1Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia; 2Faculty of Medicine, Cairo University, Cairo, Egypt

Background:

Despite all advances in the treatment of varicose vein recurrence rate still high, multiple factors were incriminated; this study aims s to evaluate the safety and efficacy of whole great saphenous vein ablation starting flush with the SaphenoFemoral Junction down to the ankle using new technique combing laser and chemical ablations.

Material(s) and Method(s):

A prospective study included patients with varicose veins presented to the vascular surgery department, Kasr Al Aini hospital in the period from May 2016 to February 2018.  All patients treated with Endogenous Laser Ablation of the whole great saphenous vein starting flush at the SFJ using radial fiber combining low laser energy with truncal injection Sclerotherapy for the below the knee vein segment with adjusted linear endovenous energy density (LEED). Patients followed up for 18 months, CIVI Q 20 was obtained before treatment and after 3-12 months.

Result(s):

This study included 125 patients (132 limbs), mean age was 40.4±11.8 years, male to female ratio was 1:2.4, CEAP classification 2-6, the presentation was bilateral in 7 patients (5. 6%).technical success was achievable in 99.3% of patients, need for extra truncal treatment in same at the time of ablation (laser, injection or phlebotomy 64 patients (48.5%), post-operative DVT 0%, saphenous nerve injury 1 case (0.7%), recanalization at 6-12-18 month 2 case (1.5%), improvement in CIVIQ20 from 71.25±9.6 to 32.4± 4.6 and 29.7±1.2 at 3&12 months respectively.

Conclusion(s):

Using the radial laser fiber allow safe flush thermal ablation of the great saphenous vein with the anticipated decrease in groin recurrence, combined with thermochemical ablation of the below the knee segment and has promising result in short and midterm follows up.