Which endovenous ablation method does offer a better long-term technical success in the treatment of the incompetent great saphenous vein? Review. (December 2016)

• Record Type: Journal Article
• Authors: Balint, Renata; Farics, Akos; Parti, Krisztina; Vizsy, Laszlo; Batorfi, Jozsef; Menyhei, Gabor; Balint, Istvan B
• Is Part Of: Vascular. Volume 24:Number 6(2016:Dec.)
• Page Start: 649
• Page End: 657
• Publication Date: 2016-12
• Subjects: Great saphenous vein -- endovenous laser ablation -- radiofrequency ablation -- ultrasound guided foam sclerotherapy; 616.13
• DOI: 10.1177/1708538116648035
• Languages: English
• ISSNs: 1708-5381

Abstract

Objective: The aim of this review article was to evaluate the long-term technical success rates of the known endovenous ablation procedures in the treatment of the incompetence of the great saphenous vein. Methods: A literature search was conducted in the PubMed-database until the 5 January 2016. All publications with four to five years follow-up were eligible. Meta-analysis was performed by the IVhet-model. Results: Eight hundred and sixty-two unique publications were found; 17 of them were appropriate for meta-analysis. Overall, 1420 limbs were included in the trial, 939 for endovenous laser ablation, 353 for radiofrequency ablation and 128 for ultrasound guided foam sclerotherapy. Overall, technical success rates were 84.8% for endovenous laser ablation, 88.7% for radiofrequency ablation and 32.8% for ultrasound guided foam sclerotherapy. There were no significant differences between endovenous laser ablation, radiofrequency ablation and ultrasound guided foam sclerotherapy regarding the great saphenous vein reopening ( p = 0.66; OR: 0.22; 95% of CI: 0.08–0.62 for radiofrequency ablation vs. endovenous laser ablation; p = 0.96; OR: 0.11; 95% of CI: 0.06–0.20 for endovenous laser ablation vs. ultrasound guided foam sclerotherapy; p = 0.93; OR: 3.20; 95% of CI: 0.54–18.90 for ultrasound guided foam sclerotherapy vs. radiofrequency ablation). Conclusion: Both endovenous laser ablation and radiofrequency ablation are efficient in great saphenous vein occlusion on the long term. Lacking long-conducted large trials, the efficacy and reliability of ultrasound guided foam sclerotherapy to treat great saphenous vein-reflux is not affirmed.