Systematic review of endovenous laser treatment for varicose veins

• Published in: British journal of surgery 2005-10, Vol.92 (10), p.1189-1194
• Main Authors: Mundy, L., Merlin, T. L., Fitridge, R. A., Hiller, J. E.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; General aspects; Humans; Laser Therapy - adverse effects; Laser Therapy - methods; Medical sciences; Middle Aged; Saphenous Vein; Treatment Outcome; Varicose Veins - surgery; Venous Insufficiency - surgery
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.5142

Background: The safety and effectiveness of endovenous laser treatment (EVLT) for varicose veins are not yet fully evaluated. Methods: Medical bibliographic databases, the internet and reference lists were searched from January 1966 to September 2004. Only case series were available for inclusion in the review. Results: Thirteen studies met the inclusion criteria. Self‐limiting features, such as pain, ecchymosis, induration and phlebitis, were commonly encountered after treatment. Deep vein thrombosis and incorrect placement of the laser in vessels were uncommon adverse events. No study has yet assessed the effectiveness of laser therapy in comparison to saphenofemoral junction ligation with saphenous vein stripping. Occlusion of the saphenous vein and abolition of venous reflux occurred in 87·9–100 per cent of limbs, with low rates of re‐treatment and recanalization. Conclusion: From the low‐level evidence available it seems that EVLT benefits most patients in the short term, but rates of recanalization, re‐treatment, occlusion and reflux may alter with longer follow‐up. The lack of such data, in addition to the small numbers of patients in the available studies, demonstrates the need for a randomized clinical trial of EVLT versus conventional surgery. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. High level evidence of benefit is lacking