Four Years Experience with 1940NM Diode Laser and Total EVLA Method. Short Term Outcomes

Abstract

Background: The use of endovenous laser ablation (EVLA) combined with other techniques, typically miniphlebectomy, is recommended to avoid undesirable complications. We decided to compare the safety and efficacy of two treatment methods – EVLA and the new breakthrough TOTAL EVLA (side brunches and perforator veins are closed by laser) and to investigate whether the TOTAL EVLA is associated with a lower complication risk.

Methods: Clinical study of patients who had undergone TOTAL EVLA or EVLA with miniphlebectomy. Evaluation of intraoperative pain, haematoma, duration of wearing compression stockings, postoperative pain and neuropathy, sick leave duration and return to physical activity. Symptoms and complaints were surveyed using a questionnaire at least 4 weeks after the operation.

Results: 60 TOTAL EVLA and 48 EVLA with miniphlebectomy patients. Patients who underwent TOTAL EVLA had a shorter period of compression usage – average 16,9 days, with EVLA - 36,16 days. Duration of haematoma: 2,16 weeks for TOTAL and 3,13 weeks for EVLA. The TOTAL group measured intraoperative pain at 4,1 (from 1 to 10), EVLA – 4,3. Six TOTAL EVLA patients didn’t feel any postoperative pain, the rest had pain for 7,6 days. All of EVLA had pain for on an average of 15,8 days. In TOTAL sick leave was for 2,8 days, in EVLA – 14,5 days. TOTAL patients returned to physical exercises in an average 8,3 days, EVLA – 39,5 days.

Conclusions: The study demonstrates that TOTAL EVLA has lower postoperative complication risks and a faster recovery than EVLA. TOTAL EVLA patients have shown better pain improvement. Treatment method proved clear impact on patients quality of life.