Long-Term Clinical and Imaging Findings in Patients with Lower Extremity Varicose Veins Treated with Endovenous Laser Treatment: A Follow-Up Study of up to 12 Years

Abstract

Introduction. This study investigates the long-term effectiveness and safety of endovenous laser treatment (EVLT) for chronic venous insufficiency (CVI), a condition commonly caused by dysfunctional valves in the venous circulation system. Materials and Methods. In this retrospective cohort study, patients underwent EVLT and were followed up for successive short intervals and one last time after a median duration of 9-year postprocedural. Pre- and postprocedure duplex ultrasound was used to assess changes in the great saphenous vein (GSV) diameter, reflux, and saphenofemoral junction incompetence. Quality of life was evaluated using the SF-36 and Aberdeen Varicose Vein Questionnaire (AVVQ). Results. Sixty-eight patients with a mean age of $52.4\pm 12.4$ years were enrolled in the study. The mean follow-up time was $8.9\pm 2.1$ years, ranging from 5 to 12 years. The mean GSV diameter significantly decreased in all patients (whole group) across proximal (from $5.8\pm 2.3$ mm to $4.2\pm 2.1$ mm), middle (from $4.7\pm 1.6$ mm to $2.8\pm 2.2$ mm), and distal (from $4.5\pm 2.3$ mm to $2.2\pm 2.2$ mm) segments, with $P<0.001$. A disease recurrence rate of 33.8% was noted, predominantly in male patients and those with larger middle GSV diameters ($\text{OR}=5.2$ ($95\%\text{CI}=1.3$-20.4) and $\text{OR}=1.5$ ($95\%\text{CI}=1$-2.1), respectively). The average follow-up time for patients without recurrence was $8.8\pm 2.1$ years. Almost half of the patients without recurrence were followed up for 10 years or more (49%). Conclusion. The efficacy of EVLT in managing varicose veins is demonstrated by its relatively low recurrence rate over a 10-year follow-up period, highlighting EVLT as a viable long-term treatment strategy.