Short Term outcome of Endovenous Laser Ablation for Management of Varicose Vein: A Prospective Observational Study

Introduction: Chronic venous insufficiency (CVI)leads to significant impairment in quality of life with substantially lower perceived health. Endovenous laser ablation (EVLA) is a minimally invasive alternative to surgery, with fewer complications and quicker recovery. This study evaluates the short-term efficacy and safety of EVLA and identifies factors associated with recurrence in a North Indian population.

Material and Method: A prospective observational study was conducted on 85 limbs from 60 patients with symptomatic varicose veins (CEAP ≥ C2) from May 2023 to Nov 2024. All underwent pre- procedural clinical and duplex ultrasound evaluation. EVLA was performed using 1470 nm LASER, with radial fiber. Follow-up was done at 1 and 3 months, with post- procedural clinical and duplex ultrasound evaluation. Outcomes were assessed using CEAP clinical class, Revised Venous Clinical Severity Score (RVCSS), Aberdeen Varicose Vein Questionnaire (AVVQ), and USG findings.

Observation and Result: Significant improvements were observed in clinical severity and quality of life scores at 3 months. Mean CEAP C score decreased from 3.60 to 1.88 (p < 0.001), mean RVCSS decreased from 8.02 to 4.26 (p < 0.001) and mean AVVQ decreased from 38.13 to 11.51 (p < 0.001). Recanalization was noted in 7.1% of limbs. Residual venous ulcers persisted in 5.9%, and pigmentation in 29.4% of the limbs. Higher BMI, greater pre-EVLA vein diameter, and lower LEED were associated with recurrence. Paresthesia occurred in 12.9% of the limbs, significantly associated with higher LEED. No cases of DVT were reported.

Conclusion: EVLA significantly improves clinical severity and quality of life in patients with CVI. The recurrence rate of 7.1% is within the lower range reported in literature. Risk factors for recurrence include high BMI and large vein diameter. Optimizing LEED and ensuring adherence to post-procedural care, including compression therapy, are essential for better outcomes.

Keywords: EVLA, Varicose Veins, LEED, CEAP, RVCSS, AVVQ, Recanalization.