Hybrid endovenous laser ablation reduces the recurrence of varicose veins below the knee compared with radiofrequency ablation: A real-world study

Introduction This study aimed to investigate the outcome of hybrid endovenous laser ablation (EVLA, 1470 nm) and radiofrequency ablation (RFA) procedures for varicose veins (VVs). Material and methods We retrospectively analyzed the clinical data of patients from July 2019 to December 2020. Eighty-four patients (121 limbs) underwent hybrid EVLA procedure, and 108 patients (151 limbs) underwent RFA procedure. The outcomes, venous clinical severity score (VCSS), chronic venous disease quality-of-life questionnaire (CIVIQ-20) score and recurrence at 1, 6, and 12 months were collected. Results No differences in complications or 24-h pain scores were noted between the two procedures, but a lower dosage of foam sclerosant was used in EVLA procedure than in RFA procedure (P<0.02). The postoperative VCSS and CIVIQ-20 scores in two groups were significantly decreased compared with the scores before the procedure, and no differences in scores were noted between the two procedures at 1 month. However, the VCSS and CIVIQ-20 scores for EVLA procedure were significantly better than those for RFA procedure at 6 and 12 months (P<0.05). Both procedures showed a similar great saphenous vein closure rate at 12 months. The EVLA procedure showed lower rates of overall recurrence (4.96% vs. 14.57%, OR: 3.27, 95% CI: 1.33-8.00, P=0.01) and recurrence below the knee (4.13% vs. 11.92%, OR: 3.14; 95% CI: 1.18-8.35, P=0.02). Moreover, the patient satisfaction score was greater for EVLA procedure than RFA procedure (P<0.02). Conclusions The hybrid EVLA (1470 nm) procedure reduces VV recurrence below the knee and results in better quality-of-life scores.