Endo-Venous Laser Therapy vs stripping: A randomized prospective comparison Nalaka Gunawansa.

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Presentation transcript:

Endo-Venous Laser Therapy vs stripping: A randomized prospective comparison Nalaka Gunawansa

Disclosure Speaker name: Nalaka Gunawansa ................................................................................. I have the following potential conflicts of interest to report: Consulting Employment in industry Shareholder in a healthcare company Owner of a healthcare company Other(s) I do not have any potential conflict of interest

Endo-Venous Laser Therapy (EVLT) Benefits EVLT is a safe and effective alternative to Surgical Stripping (SS) of the Great Saphenous Vein (GSV) in symptomatic Sapheno-Femoral Incompetence (SFI). The post-procedure morbidity is minimal Allows early return to pre-procedure functionality How does it fare head to head with surgical stripping (SS).

Methodology Randomized, prospective case control study January 2012 through July 2013 – 18 months EVLT compared to Sapheno-Femoral Ligation and SS All had duplex confirmed SFI. Recurrent SFI excluded Day case / <24hr hospital stay Follow up; 1, 2, 4, 8, 12 weeks --- 6 and 12 months Mean follow up 24 (6-80) weeks Post-procedure pain (visual analog score), wound complications, symptomatic thigh bruising and return to full functionality

Results EVLT SFL and SS N=89 138 limbs (49 bilateral, 40 uni) Local anaesthesia (66) Spinal anaesthesia (23) N = 67 102 limbs (35 bilateral, 32 uni) All under spinal

Results EVLT SS p Mean post-procedure pain score at discharge 2 4 (Unilat.), 5 (Bilateral) 0.04 Wound complications 1/138 (<1%) 3/102 (3%) 0.18 Symptomatic thigh bruising 26/138 (19%) 41/102 (40%) 0.021 Time to return to full functionality (unilat.) 2 days 4 days 0.22 Time to return to full functionality (bilat.) 6 days 0.014

Conclusion EVLT is an effective alternative to SFL and SS. Comparable short and medium term efficacy Significantly fewer post-procedure pain and morbidity. The return to full pre-procedural functionality is significantly quicker, especially after bilateral procedures. Longer follow up required to assess recurrence.