Purpose: To compare two methods of endovenous laser treatment (EVLT) for primary varicose veins of lower extremities: first-EVLT combined with high ligation of great saphenous vein using pulse mode ablation and 12 W laser ; second-EVLT without high ligation and using lower energy (10 W) and continuous mode.
Materials and methods: Ninety-three limbs of 75 patients were treated by 980 nm diode laser into the great saphenous veins from June, 2003. In the first group of 45 patients, (HL group), we performed a division of the sapheno-femoral junction after high ligation and EVLT was done with a 12 W laser in a pulse mode. In the second group of 30 patients (NL group) EVLT was performed without high ligation with a 10 W laser in a continuous mode using a laser fiber drawing device.
Results: Operation time was significantly shorter in the NL group compared to the HL group (p < 0.05), and the early occlusion rates were 100% (HL group) and 97% (NL group). Subcutaneous bleeding occurred in 9 limbs (16%) in the HL group and 2 limbs (6%) in the NL group. In the NL group there was one case complicated with thrombus which extended into the femoral vein.
Conclusion: High ligation at sapheno-femoral junction is not necessary for EVLT and a lower energy continuous mode laser induces a lower rate of complications compared with a pulse mode ablation at a higher energy level. However, close follow-up with duplex scanning is necessary in early postoperative period.
Keywords: endovascular treatment; laser; minimally invasive surgery; varicose veins.