Study of risk factors for recurrence of varicose veins after endovenous laser obliteration of the great saphenous vein to determine indications for crossectomy

Introduction . Currently, it is recommended to use lasers with a wavelength of 1470, 1560, 1940 nm, coupled with radial light guides, for EVLO. Aim . To study the risk factors for recurrence of varicose veins after endovenous laser obliteration of the great saphenous vein to determine the indications for crossectomy. Materials and methods . The study included 150 patients with varicose veins who underwent laser EVLO. There were 112 women (74.6%) and 38 (26.4%) men. The median age was 46.3 ± 9 years. Alaser with a wavelength of 1 470 nm and radial light guides were used. Phenotypic features characterizing undifferentiated connective tissue dysplasia were investigated. The study group included 75 patients who underwent crossectomy, and 33 (44%) had dysplasia. 75 patients made up the comparison group – without crossectomy, 36 (48%) – had dysplasia. Results and discussions . During 36 months of follow-up, 4 (5.3%) patients in the study group developed a recurrence of varicose veins and 14 (18.6%) in the comparison group (p = 0.0001). Studies conducted using the Cox regression method made it possible to identify independent risk factors for the development of disease recurrence: the presence of dysplasia, the number of collaterals in the zone of the sapheno-femoral anastosis, the diameter of the great saphenous vein, the diameter of v. epigastrica superficialis, as well as the thickness of the wall of the great saphenous vein. An integral assessment of independent risk factors for the development of recurrence made it possible to propose a method for determining indications for crossectomy during EVLO of the great saphenous vein. Conclusions . Risk factors for recurrence of varicose veins after EVLO of the great saphenous vein were identified, which made it possible to start developing a method for determining indications for crossectomy to reduce the number of recurrences of the disease. Acknowledgment . The study was carried out with the financial support of Saratov State Medical University as part of the scientific project NoSSMU-2022-005, the support did not affect the results of the study.