Management of primary uncomplicated varicose veins, endovenous laser ablation with sclerotherapy versus traditional surgery: which is the best option?

Aim
To compare between endovenous laser treatment (EVLT) with ambulatory phlebectomy, EVLT with injection sclerotherapy, and the standard surgical procedure.
Patients and methods
A randomized prospective study was conducted on 60 (72 limbs) patients having primary uncomplicated varicose veins and was carried out at Minia University Hospital. Patients were divided into three groups (20 patients each), each with a different intervention for varicose veins. Group A underwent endovenous laser with injection sclerotherapy, group B underwent endovenous laser with ambulatory phlebotomy, whereas group C underwent traditional surgery.
Results
Operative time and hospital stay were significantly lower in group A. There was a significant decrease in complications in patients in group A (12.5%) compared with group C (37.5%). The most common complication in groups A and B was superficial thrombophlebitis, represented by 8.3 and 12.5%, respectively, and in group C was hematoma at 12.5%. After 1-month follow-up, residual varicose veins (VV) was 4.2, 16.7, and 8.3% in groups A, B, and C, respectively. Approximately 96% of patients in group A, 83.3% of patients in group B, and 66.7% of patients in group C were satisfied.
Conclusion
The combination technique of EVLT and injection sclerotherapy appears to be a safe and an efficient treatment method for the treatment of the great saphenous vein and small saphenous vein, achieving good short-term and long-term results.