DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS
Hatem, M., Sobhy, M., Fawzy, W., Sabry, K., Al-Taher, A. (2020). DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS. EKB Journal Management System, 71(2), 457-470. doi: 10.21608/asmj.2020.125676
Mohammed Hatem; Mahmoud Sobhy; Wageh Fawzy; Karem Sabry; Ahmed Al-Taher. "DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS". EKB Journal Management System, 71, 2, 2020, 457-470. doi: 10.21608/asmj.2020.125676
Hatem, M., Sobhy, M., Fawzy, W., Sabry, K., Al-Taher, A. (2020). 'DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS', EKB Journal Management System, 71(2), pp. 457-470. doi: 10.21608/asmj.2020.125676
Hatem, M., Sobhy, M., Fawzy, W., Sabry, K., Al-Taher, A. DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS. EKB Journal Management System, 2020; 71(2): 457-470. doi: 10.21608/asmj.2020.125676

DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS

Ain Shams Medical Journal
Article 17, Volume 71, Issue 2, June 2020, Page 457-470  XML PDF (657.58 K)
Document Type: Original Article
DOI: 10.21608/asmj.2020.125676
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Authors
Mohammed Hatem1; Mahmoud Sobhy1; Wageh Fawzy1; Karem Sabry1; Ahmed Al-Taher2
1Departments of vascular surgery, Ain shams University, Cairo, Egypt.
2Department of diagnostic and interventional radiology, Ain shams University, Cairo, Egypt.
Abstract
Background: The goal of this prospective cohort study was to study the different determinants impacting primary varicose vein recurrence rates and patterns after endo venous laser ablation (EVLA) for primary lower limb varicose veins.
Patients and Methods: 127 symptomatic patients (127 limbs) with great saphenous vein reflux (>0.5 seconds), GSV diameter> 3mm and pre-operative incompetent perforators were followed up within two years for recurrence after EVLA.
Outcomes: Recurrence was defined clinically by venous clinical severity score (VCSS) and CEAP classification and radiologically by patterns of reflux on duplex ultrasound examination. Assessment was done at 1, 6, 12 and 24 months after the procedure. Results: Two-year life table analysis showed varicose vein recurrence in 9(7.1%) of limbs. Varicose vein recurrence was mostly seen owed to due to BMI more than 30.5 kg/m2 in 77.8 % (p <0.001, 95% CI 1.105 to
1.590) of recurrence patients, refluxing anterior accessory saphenous vein in 77.8% of patients (p <0.001, 95% CI 3.2 to 1669.1) and postoperative incompetent perforators in 77.8% of patients (p <0.001,95% CI 2.7 to 69.3). Age, gender and pre-operative GSV diameter ≥5.5 mm were statistically insignificant in determination of recurrence. Conclusion: BMI, refluxing anterior accessory saphenous vein and postoperative incompetent perforators are the most important determinants of recurrence after EVLA with a statistically significant impact in comparison with age, gender and preoperative dilated GSV diameter ≥5.5 mm.
Keywords
EVLA: Endovenous laser Ablation; AASV: Anterior Accessory Saphenous Vein; GSV: Great Saphenous Vein; VV: Varicose Veins; BMI: Body mass index; ROC: Receiver-operating characteristic curve
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