Correlation Between Diameter and Occlusion Rate of Great Saphenous Vein on Revised Venous Clinical Severity Score after Endovenous Laser Ablation in Chronic Venous Insufficiency Patients.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

Pre-EVLA vein diameter influences the success of post-EVLA occlusion. The degree of GSV occlusion does not affect the r-VCSS after EVLA.