EVLT with foam sclerotherapy for varicose veins: a single unit study

Wasim M. D., Azeez Pasha, U. Vasudeva Rao, Venkatesh Reddy, Sai Shruthi Rai, Sanjitha Shampur


Background: The true incidence of varicose veins in our country is not known as majority of patients with mild to moderate varicosities do not report to the physicians and only patients with complication like eczema, ulceration and bleeding are seen in clinics and hospitals. The search for a more effective means of prevention and for the perfect cure for this common condition continues. The aim of this study was to assess feasibility of Endovenous laser therapy with foam sclerotherapy for varicose veins with SFJ/SPJ incompetence.

Methods: Out of two hundred and fifty (n = 250), the most common age group was between 31-40 years. 68% were females. Left limb was more affected. The patients presented with varied symptoms, out of which painless dilated and tortuous veins was most common. Long Saphenous system was the most common venous system affected by varicosity. The median operating time for one system was 35 mins. Visual analog scale for pain (VAS) was median 1 at 24 hours. 25 patients had pain for 2 weeks, 30 patients had ecchymosis, 45 patients had neuralgia, 35 patients had pain, none of the patients had skin burns and one (1) patient developed DVT. Mean hospital stay was 1 day. Follow up at 3 months showed, no pain and no scar.

Results: In this retrospective study, we found that incidence of colorectal carcinoma is more between 40-60 years of age with male predominance; lymph node metastasis is more than metastasis in any other sites. CT scan can diagnose lymphatic metastasis and infiltration in surrounding tissue more accurately. Percentage of sphincter saving procedure were low in rectal malignancies in our study.

Conclusions: At present, endovenous laser ablation with Foam Sclerotherapy of both the GSV and SSV shows considerable promise in the treatment of varicose veins. Avulsion is not required. The advantages of this procedure include ease, safety, cosmesis and durability.


Endovenous laser therapy, Foam sclerotherapy, Varicose veins

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Callam MJ. Epidemiology of varicose veins. Br J Surg. 1994;81(2):167-73.

Poder TG, Fisette JF, Bédard SK, Despatis MA. Is radiofrequency ablation of varicose veins a valuable option? a systematic review of the literature with a cost analysis. Can J Surg. 2018;61(2):128.

Min RJ, Khilnani N, Zimmet SE. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 2003;14(8):991-6.

Bussche DV, Moreels N, Letter JD, Lanckneus M. Endovenous laser treatment for primary varicose veins. Acta chirurgica Belgica. 2006;106(1):32-5.

Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130(4):333-46.

Eissawy MG, Abd-ElGawad EA, El-Sherei EA. Endovenous laser ablation of varicose veins. Egypt J Radiol Nucl Med. 2016;47:179-83.

Tessari L. Extemporary sclerosing foam according to personal method: experimental clinical data and catheter usage. Int Angiol Suppl. 2001;1:54.

Sigg K. Newer aspects in the technique of treating varicosities. Therapeutische Umschau. 1949;6(9):127-34.

Manfrini S, Gasbarro V, Danielsson G, Norgren L, Chandler JG, Lennox AF, Zarka ZA, Nicolaides AN. Endovenous management of saphenous vein reflux. J Vascl Surg. 2000;32(2):330-42.

Sarin S, Scurr JH, Smith C. Assessment of stripping of the long saphenous vein in the treatment of primary varicose veins. Br J Surg. 1992;79(9):889-93.

Dwerryhouse S, Davies B, Harradine K, Earnshaw JJ. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. J Vasc Surg. 1999;29(4):589-92.

Pannier E, Rabe E. Mid-term results following endovenous laser ablation (EVLA) of saphenous veins with a 980 nm diode laser. Int Angiol. 2008;27(6):475.

Rass K, Frings N, Glowacki P, Hamsch C, Vogt T, Tilgen W. Comparable effectiveness of endovenous laser ablation and high ligation with stripping of the great saphenous vein: two-year results of a randomized clinical trial (RELACS study). Archiv Dermatol. 2012;148(1):49-58.

Go SJ, Cho BS, Mun YS, Kang YJ, Ahn HY. Study on the long-term results of endovenous laser ablation for treating varicose veins. Int Journal Angiol. 2016;25(2):117.

TM Proebstle, H A Lehr, A. Kargl, C. Espinola-Klein, W Rother, et al. Endovenous treatment of the greater saphenous vein with a 940-nm diode laser: Thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles. J Vasc Surg. 2002;35(4):729-36.

Satokawa H, Yokoyama H, Wakamatsu H, Igarashi T. Comparison of endovenos laser treatment for varicose veins with high ligation using pulse mode and without high ligation using continuous mode and lower energy. Ann Vasc Dis. 2010;3(1):46-51.

Vähäaho S, Halmesmäki K, Albäck A, Saarinen E, Venermo M. Five-year follow-up of a randomized clinical trial comparing open surgery, foam sclerotherapy and endovenous laser ablation for great saphenous varicose veins. Br J Surg. 2018;105(6):686-91.

Christenson JT, Gueddi S, Gemayel G, Bounameaux H Prospective randomized trial comparing endovenous laser ablation and surgery for treatment of primary great saphenous varicose veins with a 2-year follow-up. J Vasc Surg. 2010; 52(5):1234-41.

Min RJ, Khilnani N, Zimmet SE. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 2003;14(8):991-6.

Tessari L, Cavezzi A, Frullini A. Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg. 2001;27(1):58-60.

Subramonia S, Lees TA. The Treatment of Varicose Veins. Ann R Coll Surg Engl. 200;89(2):96-100.