Comparison of long-term clinical and anatomical results of endovenous cyanoacrylate embolization and endovenous laser ablation methods in the treatment of great saphenous vein insufficiency

Abstract

Objective

Although some publications are comparing the early clinical and anatomical results of endovenous laser ablation and endovenous cyanoacrylate embolization in great saphenous vein insufficiency, according to our knowledge, there are limited publications comparing the long-term clinical and anatomical results of these methods. I aimed to compare the long-term clinical and anatomical outcomes of these endovenous treatment methods.

Methods

A total of 248 patients over the age of 18 who underwent endovenous laser ablation or endovenous cyanoacrylate embolization for the treatment of great saphenous vein insufficiency were included in the study. Patients who have been treated with a treatment method other than these methods were not included in this study. The equal numbers of patients were included in two groups according to the applied treatment methods. The groups were not fully matched in terms of baseline characteristics in this study, and significant differences were detected in age and preoperative reflux duration values (p < .05), and therefore, the results were re-analyzed with models (ANCOVA) adjusted for age and clinical severity parameters.

Results

Endovenous laser ablation or endovenous cyanoacrylate embolization procedures were performed in a total of 248 patients with a mean age of 51.22 ± 13.20 years. There was a statistically significant difference in mean age between the groups (p = .017). The mean preoperative CEAP score of study patients was 3.07 ± 0.57 (between 2 and 6), and the mean preoperative VCSS value was 6.85 ± 1.18. The average follow-up period of the study patients was 3.5 ± 0.50 years and at the end of the follow-up, a decrease in CEAP stage and VCSS values was observed in both groups.

Conclusions

The endovenous cyanoacrylate embolization offers similar long-term success rates to endovenous laser ablation, is a shorter procedure time, and offers advantages in returning to daily activities after the procedure. Both treatment methods, with effective and accessible healthcare systems, offer a variety of treatment options. The results of this study suggest that while both methods reduce the CEAP stage in the long term, endovenous cyanoacrylate embolization may provide a greater reduction. However, endovenous laser ablation may be more effective in reducing symptom severity (VCSS) and may offer an effective treatment option with lower complication rates and similar outpatient benefits and cost-effectiveness.