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Clinical Research
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Prevention of Recurrent Venous Ulceration by Eliminating Saphenous Reflux: Results of Endovenous Laser Ablation First Author: William Marston Authors: W. Marston, D.F. Berndt, M. Wiener, R. Mendes, B. Keagy Introduction: Recurrence of chronic venous ulcers is frequent (>50% at 5 years) after successful healing despite the use of compression stockings. Correction of venous insufficiency by endovenous laser ablation (EVLT) may reduce the risk of recurrent ulceration. The goal of this study was to describe the hemodynamic outcome of EVLT for patients with venous ulcers and the early incidence of ulcer recurrence. Methods: Patients with healed leg ulcers and reflux in the saphenous vein(s) documented by ultrasound examination were treated with EVLT of the saphenous vein(s). Air plethysmography (APG) was performed before and after EVLT to document the hemodynamic improvement with ablation. Patients were followed at 6 month intervals to identify ulcer recurrence. Results: Thirty-five limbs with saphenous reflux and ulceration were treated with EVLT. The average patient age was 62.7 and 63% were female. Successful saphenous ablation was achieved in 97 % of patients. The average pre-ablation venous filling index (8.2 + 7.3 ml/sec) improved significantly to 4.1 + 2.7 ml/sec after EVLT (P=0.01). At a mean follow-up time of 18 months, only 3 patients (8.5%) reported ulcer recurrence. Conclusions: EVLT is a minimally invasive method to eliminate abnormal reflux in the superficial veins. For patients with leg ulceration due to saphenous disease, this method resulted in marked reduction in venous hypertension and a low incidence of ulcer recurrence. |
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