Optimal ablation length for effective treatment of great saphenous vein insufficiency

Summary: Background: Endovenous ablation methods are commonly used to treat great saphenous vein (GSV) insufficiency. However, great saphenous vein is also a valuable resource in vascular surgery. Therefore, it is important to perform minimal saphenous ablation. The aim of the study was to determine the optimal length of saphenous ablation in treatment. Patients and methods: This retrospective study was performed by measuring preoperative and postoperative venous haemodynamic parameters using plethysmography in 614 patients who required endovenous ablation. Only the segment of great saphenous vein was ablated, where the diameter was superior to 5.5 mm in standing position, starting 1 cm below the saphenofemoral junction. Patients were divided into four groups based on the length of the ablated saphenous vein at the end of 12- month. The study aimed to investigate the optimum length of ablation in dilated and insufficient GSV to preserve the GSV and improve venous haemodynamics. Results: The M age of 614 patients included in the study was 55.78 ± 15.27 years, of which 379 (61.7%) were female and 235 (38.3%) were male. A statistically significant improvement was observed in the haemodynamic values measured by plethysmography after Endo Venous Laser Ablation (p < .001). However, no statistically significant difference was found between the groups of different lengths in terms of these variables. Conclusions: Endo Venous Laser Ablation effectively treats great saphenous vein insufficiency. To protect the saphenous vein, ablation of only 10 cm from the junction of the saphenous vein may improve venous haemodynamics and reduce patient complaints. Strain gauge-venous occlusion plethysmography and similar methods can be used in conjunction with Doppler ultrasonography to assess venous haemodynamics and determine the optimal treatment.