Comparison of endovenous laser therapy versus conventional stripping of the great saphenous vein in patients with primary varicose veins
(Portuguese
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Charles Angotti Furtado de Medeiros *
*
Member of the Reference Center in Endovascular Surgery, Universidade
Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Masters
dissertation presented at the Graduate Program, Medical School, UNICAMP,
Campinas, SP, Brazil, as part of the requirements to obtain the title
of Master in Surgery, area of Peripheral Vascular Diseases.
Advisor:
Professor Dr. George Carchedi Luccas
Presentation:
February 22nd, 2005
Examiners: Prof. Dr. George Carchedi Luccas (FCM-UNICAMP), Prof. Dr. Fábio Hüsemann Menezes (FCM-UNICAMP), Prof. Dr. Miguel Francischelli Neto (Santa Casa de Limeira).
Correspondence:
Charles Angotti Furtado de Medeiros
Rua Izabel Negrão Bertoti, 101/52
CEP 13087-671, Campinas, SP, Brazil.
Tel.: (19) 3256.9771
E-mail: drcharlesangotti@hotmail.com
J
Vasc Bras. 2006;5(1):78
Abstract
submitted December 6, 2005, accepted February 14, 2006.
Introduction:
The diagnosis of varicose veins is common, affecting up to 25% of women and 15% of men. Such patients search for medical treatment for several reasons, including esthetics. The development of more adequate and flexible instruments, as well as the search for less invasive techniques with acceptable results, at short and long term, promote new therapeutic modalities.
Objetive: To compare the endovenous laser photocoagulation with an 810-nm diode and the total stripping of the great saphenous vein through a prospective, analytical study in a clinical double-blind and controlled trial.
Methods:
Twenty patients (40 lower limbs) with symptomatic varicose veins and
bilateral great saphenous vein insufficiency verified by the Doppler
ultrasonography were operated at the Hospital Estadual Sumaré, from
March 2002 to February 2004. For each case, without the patients' knowledge,
both techniques were randomly performed, one at each side.
The postoperative
assessment occurred at a medical follow-up with the application of questionnaires,
physical examination and digital photography of all patients since the
seventh postoperative day (PD). A duplex scanning was also performed
on the 30th PD and air plethysmography on the 60th
PD - by single, experienced examiners blinded to the data. This project
was approved with no restrictions by the ethics committee, and the patients
were included after signing the consent form. All data were submitted
to statistical analysis using the software SPSS.
Results:
The endovenous laser technique presented similar pain, but less edema
(P < 0.05) and less hematoma (P < 0.05) during the postoperative
period. The index of esthetic improvement and satisfaction with the
surgery was 100%, but the majority of patients reported that the limb
operated with the laser had better results (P < 0.05). There
was a hemodynamic improvement (venous filling time) in both groups,
but with no significant difference between them.
During
the follow-up (average of 9 months), there was only one case of mild
and transitory paresthesia at the conventional side and only one recanalization
at the laser side.
Conclusion:
The endovenous photocoagulation for the treatment of the great saphenous vein in patients with lower limb varicose veins is safe and well tolerated, besides presenting results comparable with the conventional stripping.
