Suhartono Raden, Rinaldi Ivan, Vidiawati Sanyoto Dhanasari, Adriani Januar Rizky, Faruk Muhammad
Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Ann Vasc Surg. 2025 Sep;118:11-20. doi: 10.1016/j.avsg.2025.03.021. Epub 2025 Apr 14.
The effectiveness of endovenous laser ablation (EVLA) on the diameter of the large saphenous vein is still widely debated, as the larger diameter of the saphenous vein has a lower occlusion rate after EVLA and can affect the Revised Venous Clinical Severity Score (r-VCSS) value. This study aims to determine the relationship between the diameter and occlusion rate of the great saphenous vein (GSV) post-EVLA.
This study was a cross-sectional design of patients with chronic venous insufficiency in the GSV who underwent EVLA. Thirty-seven extremities from 34 patients underwent a 1,470-nm EVLA with a radial tip. The diameter of the GSV was measured using Doppler ultrasound in 4 segments (3 femoral, 1 cruris), and pre-EVLA r-VCSS was also assessed. One week after EVLA, GSV occlusion was assessed using Doppler ultrasound and r-VCSS values.
Per observations, 13.5% of cases failed occlusion 1 week post-EVLA. All occlusion failures occurred at the one-third proximal of the femoral segment (diameter >10 mm) (P < 0.05). There was no significant difference between occlusion rates with r-VCSS, comparing pre-EVLA and post-EVLA (P = 0.490 and P = 0.102). The difference in diameter according to the cut value does not affect the r-VCSS after the procedure.
Pre-EVLA vein diameter influences the success of post-EVLA occlusion. The degree of GSV occlusion does not affect the r-VCSS after EVLA.
静脉腔内激光消融术（EVLA）对大隐静脉直径的有效性仍存在广泛争议，因为大隐静脉直径较大时，EVLA术后闭塞率较低，且会影响修订的静脉临床严重程度评分（r-VCSS）值。本研究旨在确定EVLA术后大隐静脉（GSV）直径与闭塞率之间的关系。
本研究为对接受EVLA的GSV慢性静脉功能不全患者的横断面设计。34例患者的37条肢体接受了1470nm径向尖端的EVLA。使用多普勒超声在4个节段（3个股段，1个小腿段）测量GSV直径，并评估EVLA术前的r-VCSS。EVLA术后1周，使用多普勒超声和r-VCSS值评估GSV闭塞情况。
根据观察，13.5%的病例在EVLA术后1周闭塞失败。所有闭塞失败均发生在股段近端三分之一处（直径>10mm）（P<0.05）。比较EVLA术前和术后，r-VCSS的闭塞率之间无显著差异（P=0.490和P=0.102）。根据临界值的直径差异在术后不影响r-VCSS。
EVLA术前静脉直径影响EVLA术后闭塞的成功率。GSV闭塞程度不影响EVLA术后的r-VCSS。
