Retrospective review of endovenous thermic ablation alone versus combined with phlebectomy in the management of varicose veins

Gerardo Martinez Mendez; Alan Isaac Valderrama Trevino; Miguel Angel Sierra Juarez; Marlon Eduardo Lacayo Valenzuela

doi:10.18203/2349-2902.isj20243006

Authors

Gerardo Martinez Mendez Department of Angiology and Vascular Surgery, Hospital General de Mexico, “Dr. Eduardo Liceaga”, CDMX, Mexico
Alan Isaac Valderrama Trevino Department of Angiology and Vascular Surgery, Hospital General de Mexico, “Dr. Eduardo Liceaga”, CDMX, Mexico
Miguel Angel Sierra Juarez Department of Angiology and Vascular Surgery, Hospital General de Mexico, “Dr. Eduardo Liceaga”, CDMX, Mexico
Marlon Eduardo Lacayo Valenzuela Department of Angiology and Vascular Surgery, Hospital General de Mexico, “Dr. Eduardo Liceaga”, CDMX, Mexico

DOI:

https://doi.org/10.18203/2349-2902.isj20243006

Keywords:

CVD, Endovenous ablation, Phlebectomy, Varicose veins, Recurrence

Abstract

Background: Chronic venous disease (CVD) affects 25-30% of the adult population in developed countries, significantly impacting quality of life. Endovenous thermal ablation (EVTA) has replaced traditional saphenectomy, but the benefit of combining it with phlebectomy remains debated. This retrospective study compares varicose vein recurrence after EVTA with and without phlebectomy.

Methods: A total of 155 patients from the general hospital of Mexico between 2021 and 2024, classified as CEAP C2-C6, were analyzed. Of these, 83 underwent EVTA with phlebectomy, and 72 underwent only EVTA. Demographic data were analyzed, and recurrence rates, technical success, and complications were compared using chi-square and student’s t tests (p<0.05).

Results: Recurrence rates were lower in the phlebectomy group (14.5%) compared to the non-phlebectomy group (27.2%, p=0.04). The success rate was higher in the phlebectomy group (86.7%) compared to EVTA alone (65.2%, p=0.003). There were no significant differences in complications between the groups.

Conclusions: EVTA with phlebectomy demonstrated better outcomes in terms of recurrence and clinical success. However, minor complications such as bruising should be considered when choosing the treatment.

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