Comparative effectiveness of endovenous laser coagulation techniques in preventing recurrences of varicose vein disease in the lower extremities

Introduction . In recent years, endovenous laser coagulation (EVLC) has become the primary method for treating varicose vein disease of the lower extremities. However, the long-term clinical outcomes of EVLC are similar to those of classical surgical interventions, while the anatomical causes of recurrence identified through duplex scanning differ. Aim . To compare the recurrence rates of varicose vein disease after isolated EVLC of the great saphenous vein (GSV) and a combined procedure that includes the anterior accessory vein (AASV) in the long-term postoperative period. Materials and methods . A comparative study was conducted involving 162 individuals with varicose veins in the legs. All participants underwent EVLC of the GSV. The patients were divided into two groups: Group I consisted of 81 individuals who underwent isolated EVLC of the GSV; Group II included 81 individuals who underwent combined EVLC of the GSV and AASV. Results . Early postoperative complications revealed no statistically significant differences between the groups. According to the results of follow-up ultrasound duplex scanning performed three years after the surgery in Group I (EVLC of GSV), the reflux rate in the thigh area was statistically significantly higher at 15 (18.5%) compared to Group II 1 (1.2%) (EVLC of GSV + AA SV). This difference was statistically significant (p < 0.05). Discussion . The studies show that preventive EVLC of the AASV significantly reduces the recurrence rates of varicose vein disease by 25%. Conclusions. Obliteration of the AASV, regardless of the presence of reflux and their size, is a justified strategy for reducing the number of recurrences in the long-term postoperative period.