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Endovenous Laser Treatment for Varicose Veins: Experience in a Large Academic Institution: Presented at SIR

By Marvin Ross

TORONTO, CANADA -- April 3, 2006 -- A study designed to evaluate the safety and efficacy of endovenous laser treatment (EVLT) for varicose veins demonstrated that this technique can be applied safely and effectively to a heterogeneous population of patients in an outpatient setting.

Researcher Herlen Alencar, Brigham and Women's Hospital, Boston, Massachusetts, United States, told a session here on April 1^st at the 31^st Annual Scientific Meeting of the Society of Interventional Radiology (SIR) that not only was this study one of the largest series to date but it reflected real life.

Dr. Alencar conducted his research with Richard A. Baum, MD, chief, Division of Angiography and Interventional Radiology, Brigham and Women's Hospital. The data were obtained from consecutive patients treated by 7 different operators, all of whom had differing levels of expertise.

The researchers evaluated the electronic charts of all patients treated in the Brigham outpatient clinic from October 2003 to August 2005. A total of 563 procedures were performed in this period and 190 of them were analyzed for this study. Only refluxing varicose veins were included in the study.

The ratio of females to males was 10:1 and the mean age was 49.7 (22-80). In 80% of cases, the treated vein was the great saphenous -- 42.1% right side and 41% left side. The average diameter of the treated vein was 8.7 mm (2-24 mm). The access puncture site was below the knee joint in 43% of the cases, above the knee in 30.1% of the cases, at the knee joint in 11.5%, and above and below in 5%. The mean energy delivered per treatment was 2,386 J.

An evaluation performed 2 weeks after the procedure showed that 96% of the treated veins were occluded. Success was defined as the absence of blood flow. A further follow up done 2 to 3 months after the procedure found that the success rate was maintained.

Minor complications were noted in 10.5% of patients, with the most common complication being induration along the length of the treated occluded veins. Mild to moderate pain and phlebitis were also noted in some patients.

Dr. Alencar concluded by pointing out that while this study lacked long-term follow-up of patients, it has been shown in the literature that the majority of recurrences occur within the first 3 months post-procedure. It can therefore be expected that very few recurrences will be seen in these patients after their final 3-month follow-up for the study, he said.


[Presentation title: Endovenous Laser Treatment (EVLT) for Varicose Veins: Experience in a Large Academic Institution. Abstract 52]

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