How does endovenous laser ablation therapy (EVLA) compare with conventional surgical repair for people with short saphenous varicose veins?

Abstract

For people with short saphenous varicose veins, evidence shows that EVLA probably leads to fewer people having recanalization or persistence of reflux at six weeks (18 vs 212 per 1000 people; moderate‐certainty evidence) compared with conventional surgery, and may lead to fewer recurrences of reflux at one year (54 vs 196 per 1000 people; low‐certainty evidence), with little or no important difference between groups in reintervention due to technical failure or in disease‐specific quality of life (Aberdeen Varicose Veins Questionnaire; AVVQ) at six weeks and at one year. Probably fewer people experienced sural nerve injury at six weeks with EVLA (7% vs 29%); other complications (wound infection, hematoma, pigmentation/bruising, phlebitis) were infrequent and were assessed in too few participants. Fewer people may present clinical evidence of recurrence after one year (104 vs 176 per 1000 people), but this effect was imprecise.