Twenty Years' Experience with Endovenous Laser Ablation for Varicose Veins: A Critical Appraisal of the Original Procedure.

Objective: A critical appraisal of the original procedure of endovenous laser ablation (EVLA) for varicose veins.

Method: Evaluation of all practical aspects of the procedure.

Results: EVLA procedures are performed in a strictly ambulatory setting with tumescent local anesthesia (TLA).

Five-year results of a randomized clinical trial comparing endovenous laser ablation with cryostripping for great saphenous varicose veins.

Background: This was the long-term follow-up of a previously reported randomized clinical trial comparing endovenous laser ablation (EVLA) with cryostripping for great saphenous varicose veins.

Methods: A total of 120 patients with great saphenous varicose veins were randomized 1:1 to EVLA or cryostripping. Principal outcome measures were freedom from incompetence or neovascularization on duplex imaging, and improvement in Venous Clinical Severity Score (VCSS) and Aberdeen Varicose Vein Severity Score (AVVSS) 5 years after treatment.

Five-year results of a randomised clinical trial of endovenous laser ablation of the great saphenous vein with and without ligation of the saphenofemoral junction.

Objective: To evaluate whether ligation of the saphenofemoral junction (SFL) improves the results of endovenous laser ablation (EVLA) of the great saphenous vein (GSV) in a 5-year randomised clinical trial (RCT).

Methods: Forty-three symptomatic patients (86 limbs) with bilateral incompetent GSVs were randomised so that one limb underwent EVLA without SFL and the other limb underwent EVLA with SFL. Eleven patients were lost to follow-up and two patients died, leaving 30 patients (60 limbs) for analysis.

Histopathologic studies of the below-the-knee great saphenous vein after endovenous laser ablation.

Background: There has been hesitation to use endovenous laser ablation (EVLA) for the treatment of incompetence of the below-the-knee great saphenous vein (GSV).

Objective: To assess early pathologic changes in the below-the-knee nonvaricose GSV and adjacent tissue after EVLA in legs scheduled for below-the-knee amputation.

Methods: The below-the-knee GSV in five patients was exposed to EVLA using 14-, 12-, and 10-watt laser power with continuous or intermittent laser exposure using a 600-nm core, bare tip fiber.

Randomised comparison of costs and cost-effectiveness of cryostripping and endovenous laser ablation for varicose veins: 2-year results.

Background: Although endovenous laser ablation for varicose veins is replacing surgical stripping, proper economic evaluation with adequate follow-up in a randomised clinical trial is important for considered policy decisions regarding the implementation of new techniques.

Methods: Data from a randomised controlled trial comparing cryostripping and endovenous laser ablation in 120 patients were combined to study Short Form (SF) 6D outcome, costs and cost-effectiveness 2 years after treatment. Incremental cost per quality-adjusted life year (QALY) gained 2 years after treatment was calculated using different strategies, and uncertainty was assessed with bootstrapping.