The clinical significance of below-knee great saphenous vein reflux following endovenous laser ablation of above-knee great saphenous vein

AimsThe standard technique for endovenous laser ablation (EVLA) for varicose veins due to great saphenous vein (GSV) reflux involves obliteration of the above-knee (AK) GSV. This study assesses the significance of persistent below-knee (BK) GSV reflux following such therapy.MethodsSixty-nine limbs (64 patients) with varicosities and GSV reflux underwent AK-EVLA. Post treatment, GSV reflux (ultrasound: six, 12 weeks) and Aberdeen varicose vein severity scores (AVVSS, 12 weeks) were assessed, and residual varicosities treated with foam sclerotherapy (six weeks).ResultsThe untreated BK-GSV remained patent in all limbs. Ultrasound showed normal antegrade flow in 34/69 (49%, Group A), flash reflux 1 s reflux in 28/69 (41%, Group C). Although AVVSS improved in all groups (P < 0.001): A: 14.6 (8.4–19.3) versus 2.8 (0.5–4.4), B: 13.9 (7.5–20.1) versus 3.7 (2.1–6.8), C: 15.1 (8.9–22.5) versus 8.1 (5.3–12.6) the improvement was less in Group C (P < 0.001 versus A and B) and was asso...