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Editor's Choice - Mid-term Outcomes of Endovenous Laser Ablation in Patients with Active and Healed Venous Ulcers: A Follow-up Study
Department of Vascular Surgery, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Venous Centre, Stockholm, Sweden.
Department of Vascular Surgery, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0003-4222-6721
2017 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 53, no 5, p. 710-716Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this study was to assess the mid-term ulcer recurrence rate in patients with healed or active venous ulcers treated with endovenous laser ablation (EVLA) for incompetent superficial axial veins and to search for possible risk factors for non-healing and recurrence.

METHODS: Consecutive patients treated with EVLA because of a healed or active venous ulcer between 2006 and 2013 were identified in the medical records and quality registry and invited to follow-up, including clinical history, study examination, Duplex ultrasound scanning, ankle brachial pressure, photoplethysmography, venous clinical severity score (VCSS), and health related quality of life (HRQoL) measured with EQ5D. Of 228 patients, 170 (195 legs) fulfilled the inclusion criteria. Twenty patients were interviewed by phone, 27 were unreachable and 11 were excluded. Univariate and multivariate regression analyses were performed to identify possible risk factors for recurrence.

RESULTS: The mean follow-up time was 41 months (range 14-89 months). The average age was 66.6 years (range 36-87 years). All 86 legs operated on for an active ulcer had this ulcer healed sometime between the operation and the study examination, but thereafter it recurred in 14 patients (16%). In 109 legs operated on for a healed ulcer, the ulcer recurred in 17 legs (16%). Complications such as permanent sensory loss were seen in 16 legs (8%) and deep venous thrombosis in two legs (1%). Thirty legs (15%) were re-treated for superficial venous incompetence (SVI). Reduced ankle mobility was a risk factor for recurrence in both univariate and multivariate analysis (p=.048).

CONCLUSIONS: These midterm results demonstrate that endovenous laser ablation of SVI in patients with healed or active venous ulcers achieves good healing and low ulcer recurrence rates, with a low rate of complications and an acceptable re-intervention rate.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 53, no 5, p. 710-716
Keywords [en]
Endovenous laser ablation, Mid-term outcomes, Perforator vein incompetence, Ulcer recurrence, Varicose veins, Venous ulcer
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-78154DOI: 10.1016/j.ejvs.2017.02.028ISI: 000401678900021PubMedID: 28408089Scopus ID: 2-s2.0-85017393495OAI: oai:DiVA.org:oru-78154DiVA, id: diva2:1373225
Available from: 2019-11-26 Created: 2019-11-26 Last updated: 2020-02-14Bibliographically approved

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