Randomized clinical trial of endovenous laser ablation versus steam ablation ( LAST trial) for great saphenous varicose veins  

Oleh:

Bos, R.R. van den ; Malskat, W.S.J. ; Maeseneer, M.G.R.De ; Roos, K.P. de

Jenis: Article from Article - diterbitkan di jurnal ilmiah internasional
Dalam koleksi: BJS: British Journal of Surgery vol. 101 no. 09 (Aug. 2014), page 1077-1083.
Topik: laser ablation; varicose vein; varises; veins; thermal ablation therapies; treatments; pembuluh darah; bius lokal

Ketersediaan

Perpustakaan FK Nomor Panggil: B15.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Background The aim was to compare endovenous laser ablation (EVLA) and endovenous steam ablation (EVSA) for great saphenous varicose veins in a non-inferiority study. Methods Patients with primary great saphenous vein reflux were randomized to EVLA (940?nm) or EVSA (SVS™). Primary outcomes were treatment success (vein obliteration) at 52?weeks, and Venous Clinical Severity Score (VCSS) at 12?weeks. Secondary outcomes were pain, satisfaction with treatment, duration of analgesia use and days lost from daily activities, changes in Aberdeen Varicose Vein Questionnaire (AVVQ) and EQ-5D™ scores after 12?weeks, and complications at 2 and 12?weeks. Results A total of 227 legs were treated (EVSA, 117; EVLA, 110); 36 legs treated with EVSA received a low dose and the remaining 81 a higher dose. At 1 year, the treatment success rate after high-dose EVSA was not inferior to that of EVLA: 92 (95 per cent confidence interval (c.i.) 86 to 98) versus 96 (92 to 100) per cent respectively. Changes in VCSS after 12?weeks were similar: -2·69 (95 per cent c.i. -2·34 to -3·04) and -2·51 (-2·10 to -2·93). AVVQ, EQ-5D™ and EQ VAS scores improved equally 12?weeks after both treatments. Patients treated with EVSA reported less postprocedural pain, fewer days of analgesia use, were more satisfied with therapy, and had a shorter convalescence. Complication rates were comparable. Conclusion The 1-year treatment success of high-dose EVSA was not inferior to that of EVLA. Several secondary outcomes were in favour of EVSA

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