Endovenous laser therapy vs. high ligation/stripping for varicosity of the great saphenous vein Clinical and sonographic findings

Summary Introduction: Varicosis therapy options in- clude a combination of crossectomy/strip- ping and the endoluminal laser therapy, however, to date lacking statistically relevant data. Material and Methods: In an open multi- centre, randomized 3-arm-trial sonographic and clinical parameters were compared peri- operatively, and after 2 and 6 months be- tween endoluminal venous laser therapy, high ligation, and invaginating stripping. (Laser: 980 nm Biolitec © , Continous-Mode, 30 W). Data of 449 patients were available for the perioperative and 2 months examin- ation. 388 patients were followed up until 6 months. We compare clinical recurrencies, so- nographic reflux findings, and refluxive side branches in the inguinal region at the saphe- nofemoral junction. Results: We found significantly more reflux- ive side-branches in the laser groups, how- ever, no statistically significant relation be- tween clinical recurrencies and sonographic reflux. Over the time, there were no intraindi- vidual constant refluxes. Regarding the further endpoints edema, lymphatic edema, local disturbancies of sensibility and irritations of the saphenous nerve, matting and postop- erative restricitions, lymphatic edema, local disturbancies of sensibility and irritations of the saphenous nerve were significantly more present in the two laser groups. Discussion: In a long time follow-up we have to investigate the importance of refluxive side- branches for the development of clinical recur- rencies. According to the findings on side ef- fects, the tested laser technique is not less harmful to the patients than open surgery.