Background
Endovenous laser ablation (EVLA) is of no standardized settings, particularly the laser power that remains under question.
Objective
To assess the safest power of laser with maximal effect and least complications in ablation of varicose veins.
Patients and methods
A prospective observational randomized study inducing EVLA of different laser power settings (7 and 10 W) with preoperative assessment, then follow-up by CEAP [classification stands for Clinical (C), Etiological (E), Anatomical (A), and Pathophysiological (P)] and venous clinical severity score (VCSS), and duplex ultrasound as well as postoperative complications.
Results
This study included 50 patients (52 limbs). Preoperative complaint was mainly in the form of pain on standing and prominent varicosities. The patients were distributed as regards laser power used into two groups (7, 10 W) of 26 limbs for each one. There was a significant difference (<0.05) between both groups of patients as regards VCSS after 3 months being better in the 10 W group. As regards great saphenous vein measure changes, there was a high significant difference (<0.001) between those exposed to laser power 7 W in comparison with those of 10 W at 1- and 3 months follow-up in relation to preoperative measures showing more reduction in the 7 W group. Statistically, there was no significant difference between 7 and 10 W groups as regards time to return to work, CEAP [classification stands for Clinical (C), Etiological (E), Anatomical (A), and Pathophysiological (P)] scores, and postoperative complications, except significant differences in pain over the treated vein being less in the 7-W laser power group.
Conclusion
About 10-W laser power of EVLA was associated with better postoperative VCSSs, despite different power settings were not affecting time of return to work and other postoperative complications apart from less pain over treated veins with 7-W laser power. We call for further studies of large size and long follow-up due to few available related studies.