Clinical Study of Endovenous Laser Treatment in Short Saphenous Vein Varicosity

ABSTRACT

PURPOSE: With regard to the selection of varicose treatment, conventional therapy such as stripping and ligation has became unpopular but the selection of endovenous radiofrequency coagulations (RF) or endovenous laser treatment (EVLT) of the greater saphenous varicose vein have increased as they are more convenient for patient. Mipiphlebectomy (MP) and sclerotherapy (SC) have also been welcome due to the advantages of less scaring and a rapid return to work. Therefore, varicose vein of the greater saphenous vein (GSV) and its tributaries are well controlled by new modalities, such as RF, EVLT, MP and SC, but those of the short saphenous vein (SSV) are difficult to control because of the many tributaries and perforating veins. A new modality with a simultaneous EVLT +/-MP combination for the treatment of SSV varicosities has been used. METHOD: 27 cases of SSV varicosities in 24 patients, between Feb 2002 and May 2004, were included in this study. The series of patients were followed up for recurrence of varisose vein, SSV recanalization and complications. RESULT: The patients were grossly examined postoperatively, and doppler were checked, and the varicose recurrence rates at 1, 3 and 6 months were found to be 0, 7.4 (2/27) 25.9% (7/27), espectively, the Doppler SSV recanalization rates at 1, 3 and 6 months were 0, 0 and 11.1% (3/27) and tributaries recurrence rates were 0, 7.4 (2/27) and 14.8% (4/27) with recurrence controlled by MP or SC, or observed for progression only. Most patients (93.6%) were satisfied with our treatment modality, and complications, such as pain, hematoma and swelling were controlled within 1 month, with 3 cases of tingling sensation of calf that subsided spontaneously. CONCLUSION: The control of SSV varicosities wes a little hard due to the many recurrences after surgery or EVLT alone. In our study, the cases of SSV varicosity alone were collected, and combination therapy, such as EVLT with miniphlebectomy, wes effective, as indicated by the relatively few recurrences, and even in these recurrence cases, additional postoperative MP or SC was enough for patient's satisfaction.