مرکز منطقه ای اطلاع رساني علوم و فناوري - A Comparison Of Mini-incisional Ligation, Laser Ablation And Cyanoacrylate Embolization For Incompetent Perforating Vein Closure

Abstract :

Objective: Our aim was to compare the short- and the midterm results of three main methods of incompetent perforating vein treatment. Methods: Data of 174 procedures performed between January 2012 and January 2015, in a 84 consecutive patients with incompetent perforating veins were retrospectively analyzed. Patients were divided into 3 groups according to surgical technique: mini-incisional ligation 40 (47.6%), 22 (26.2%) endovenous laser ablation and 22 (26.2%) cyanoacrylate embolization. Preoperative, operative and early follow up data was recorded. All patients were called to assess by ultrasonography for recurrence. Results: Operation time was significantly longer in the mini-incisional ligation group (p 0.001). Cyanoacrylate group showed significantly lower hospital stay (p 0.001), duration of analgesia (p 0.001) and disability (p 0.001). Recurrence was not found in the ligation group (p 0.001), endovenous laser group showed significantly higher recurrence than the cyanoacylate group (p 0.001). Cosmetic problems (hyperpigmentation or scar tissue) were significantly higher in the mini-incisional ligation group (p =0.003). Paresthesia was detected after endovenous laser (p=0.001). Conclusion: Although ligation has still lowest rate of recurrence after incompetent perforating vein surgery, it is being replaced by the endovascular procedure due to cosmetic problems. Cyanoacrylate embolization seems to be a promising alternative for incompetent perforating veins treatment due to higher recurrence and complication rate after endovenous laser ablation.