What is the optimal treatment technique for great saphenous vein diameter of ≥10 mm? Comparison of five different approaches

Abstract

Objective

We aimed to investigate the efficacy and safety of five different treatment approaches in patients with a great saphenous vein (GSV) diameter of ≥10 mm.

Methods

A total of 697 extremities of 671 patients who were diagnosed with a GSV diameter of ≥10 mm underwent conventional surgery or endovenous therapy for symptomatic varicose veins between January 2012 and January 2017 were included in this retrospective study. All extremities included in the study were divided into five groups as follows: high ligation + stripping (HLS), radiofrequency ablation (RFA), cyanoacrylate closure (CAC), endovenous laser ablation (EVLA) procedures at 980 nm and 1,470 nm wavelengths.

Results

Among all groups, despite lower recurrence rates in HLS group than the other groups, there was no significant difference at 6 months and 1 year among the HLS, EVLA at 1,470 nm wavelength, and RFA groups. The recurrence rates of EVLA at 980 nm wavelength and CAC groups were found higher than other groups.

Conclusions

In conclusion, our study results show that although HLS seems to be an effective method for the treatment of a GSV diameter of ≥10 mm with a low recurrence rate, it does not statistically significantly differ from EVLA at 1,470 nm wavelength and RFA. Therefore, we believe that EVLA at 1,470 nm wavelength and RFA can be preferred over HLS with low pain scores in this patient population.

Keywords:

• Chronic venous insufficiency
• cyanoacrylate
• endovenous laser ablation
• great saphenous vein
• radiofrequency ablation
• stripping

Disclosure statement

No potential conflict of interest was reported by the authors.