Venous Hemodynamic Outcomes in Patients with Primary Varicose Vein Treated with High Ligation with Stripping, Endovenous Laser Ablation, and Radio Frequency Ablation
10.37923/phle.2024.22.1.20
- Author:
Choshin KIM
1
;
Hyoshin KIM
;
Joonkee PARK
;
Shin-Seok YANG
;
Dong-Ik KIM
Author Information
1. Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Publication Type:Original Article
- From:
Annals of phlebology
2024;22(1):20-26
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:To determine hemodynamic changes after surgical treatment for great saphenous vein (GSV) incompetence.
Methods:According to clinical, etiological, anatomical, and pathophysiological classification, all patients were classified as C2EpAsPr. A total of 976 limbs of 900 patients with primary varicose veins who underwent surgical treatment at the Samsung Medical Center were retrospectively reviewed. Surgical modalities were high ligation (HL) with stripping, endovenous laser ablation (EVLA), and radiofrequency ablation (RFA) of GSV.Hemodynamic changes were measured using air plethysmography preoperatively and 1 and 6 months postoperatively. Duplex scans were performed to evaluate the GSV status after surgery.
Results:Of the 900 patients, 250, 139, and 511 underwent EVLA, RFA, and HL with stripping, respectively. All groups showed a significant increase in the ejection fraction (EF) and a decrease in the venous volume (VV), venous filling index (VFI), and residual volume fraction (RVF) at 1 month postoperatively, compared with the corresponding preoperative values. When the rate of reduction was compared between the treatment modalities, the 1-month postoperative rate of reduction in the VV was higher in the RFA group and those of the VFI, EF, and RVF were higher in the HL with stripping group, compared with the other groups (p<0.05). The GSV occlusion rates at 1 and 6 months were 85.6% and 97.5% in the EVLA group and 95.7% and 99.4% in the RFA group, respectively.
Conclusion:All three surgical modalities improved the hemodynamic parameters after treatment for GSV incompetence. Thus, appropriate surgical methods can be selected according to the patient’s condition and physician’s preference.
