Conventional Surgery versus Endovenous Laser Ablation in Treatment of Primary Varicose Veins

Abstract

P rimary varicose vein disease constitutes one of the most frequent inherited disorders worldwide; according to previous epidemiological studies, varicose vein disease affects 10–20% of the population in the Western world and lower prevalence in other parts of the world. Conventional surgical management for varicose veins entails flush ligation of the SFJ, LSV stripping and stab avulsions of the varicosities. Although this surgical modality is safe and effective at short-term and midterm follow-up, it is not rare for recurrence, hematoma, and skin infection to occur after the surgical procedure. Rarely, massive bleeding due to injury to femoral veins, or even to the femoral artery during surgery, and mortality from pulmonary embolism and DVT can happen. Therefore, novel treatment modalities have been developed over recent years to overcome the limitations of conventional surgery. Within the last two decades, radiofrequency ablation and endovenous laser treatment (EVLA) have been introduced as an important new endovenous ablative techniques for the minimally invasive treatment of superficial venous reflux and varicose veins. Therefore, we performed the present systematic review and meta-analysis in order to evaluate the short and long-term outcomes of EVLA compared to conventional surgery.