Endovenous Laser Treatment for Varicose Veins in Patients with Active Ulcers: Measurement of Intravenous and Perivenous Temperatures during the Procedure

BACKGROUND Conventional saphenous vein stripping is difficult to be indicated for the treatment of varicose veins in patients classified as CEAP C4, C5, or C6. OBJECTIVE This study was developed to evaluate treatment results for varicose veins with active ulcers using endovenous laser (EVL), compared to a group undergoing clinical treatment, during 1 year. PATIENTS AND METHOD Fifty-two patients presenting with varicose veins with active ulcers for more than 1 year were divided for treatment into two randomized groups: Group 1, clinical treatment, composed of 25 subjects, was submitted to elastic or inelastic compression therapy; Group 2, EVL treatment, composed of 27 subjects, was submitted to great and or small saphenous vein ablation with a 980-nm diode EVL, plus the clinical treatment. Intravenous and perivenous temperatures were measured continuously during the EVL treatment. All patients were followed for 12 months and studied with ultrasound at the beginning and end of the study. The ulcers' areas were evaluated initially and at every 3 months. RESULTS In 12 months, 81.5% of the wounds in patients in Group 2 and only 24% in patients in Group 1 had healed. Ulcer recurrence rate was 44.4% in Group 1. The mean wound area in Group 1 decreased from 17.48 to 12.76 cm2 at the end of the year. In Group 2, the wound area decreased from 22.26 to 2.7 cm2 (p=.0037). Mean intravenous and perivenous temperatures of 79.3 and 43.0°C were recorded. CONCLUSION The treatment for varicose veins with EVL is safe in patients with active ulcers. Wounds healed faster than in patients undergoing clinical treatment alone during a 1-year period. There was no ulcer recurrence in patients treated with EVL.