Experimental determination of the best time and duration for endovenous great saphenous vein electrocoagulation.

Objective Endovenous electrocoagulation provokes immediate selective venous wall necrosis. In this study, we aim to determine the best power and time of electrocoagulation necessary to cause intima and media but not adventitia layer damage in great saphenous vein (GSV) insufficiency treatment. Methods We studied 100 varicose GSV fragments submitted to endovenous electrocoagulation. The power (60, 90, or 120 W) and time (5, 10, or 15 seconds) were randomly assigned. The fragments were submitted to histopathologic examination to analyze the depth of tissue necrosis. Dose-response models for the analysis of binary data were used to identify the best association between power and the time of electrocoagulation necessary to cause intima and media but not adventitia layer necrosis. We also applied a logistic regression model to investigate the impact of body mass index and GSV diameter on the electrocoagulation effects. Results The time (odds ratio [OR], 1.26; P  = .0009) was found to be a stronger predictor of the depth of vessel necrosis than the power of electrocoagulation applied (OR, 1.05; P P  = .82) and body index mass (median, 24.7 kg/m 2 ; minimum, 15.6 kg/m 2 ; maximum, 36.2 kg/m 2 ; OR, 1.08; P  = .26) showed a poor correlation with the depth of histologic vessel destruction. Conclusions The time of electrocoagulation strongly predicts the depth of GSV wall necrosis more than the amount of power applied. Determination of the best time and power of electrocoagulation ratio may help optimize GSV endovenous electrocoagulation closure rates and decrease the complications index. The GSV diameter and body mass index do not influence endovenous electrocoagulation effects.