Original Articles
Management of Lower Limb Varicose Veins Using Endovenous Laser Ablation, Micro-Phlebectomy, and Sclerotherapy Using Multimodal Analgesia
Fahmi H. Kakamad, Fuad E. Fuad, Soran H. Tahir, Ayoob A. Mohammed, Rezheen J. Rashid, Hiwa O. Abdullah, Dana H. Mohammed Saeed, Kanaw A. Salih and 9 more
IntroductionPreviously, the conventional surgical procedure of high-ligation and saphenous stripping was commonly used to treat varicose veins (VVs). However, contemporary advancements have led to the rapid evolution of VV management. This study shares a single center's experience in treating patients with lower limb VVs through endovenous laser ablation in combination with phlebectomy and sclerotherapy using multimodal analgesia.
MethodsThis case series study included consecutive patients diagnosed with lower limb VVs. The inclusion criteria encompassed VVs categorized from score C1 to C6 clinical, etiologic, anatomic, and pathophysiological (CEAP), saphenofemoral incompetence, and patients aged between 18 and 75.
ResultsA total of 153 patients were enrolled. The majority were female (73.0%), resulting in a female-to-male ratio of 2.73:1. The age of patients ranged from 18 to 73 years, with a mean age of 40.8 ± 11.7 years. Regarding post-procedural complications, wounds developed in 25 patients (16.3%), making it the most common complication, while thrombophlebitis occurred in 15 cases (9.8%), skin discoloration in nine cases (5.9%), and recanalization and DVT each in a case (0.7%). Due to extensive varicose veins, 31 patients (20.0%) required a sclerotherapy session six weeks after the operation. Patients could return to routine daily activities within 4 to 10 hours. Overall, the patient satisfaction rate (complete and partial) was 85%. Only a case of recurrence (0.7%) was reported after a one-year follow-up.
ConclusionEndovenous laser ablation, in combination with phlebectomy and sclerotherapy using multimodal analgesia, may yield a satisfactory outcome in patients with moderate to severe VVs.
Keywords Varicose veins
· Endovascular laser ablation
· Saphenous vein
· Microphlebectomy
· Venous insufficiency
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