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Great saphenous vein GSV incompetence is the most common cause of superficial venous insufficiency Radiofrequency catheter ablation RFA is superior to conventional ligation and stripping and endovenous laser treatment EVL has emerged as an effective alternative to RFA This randomized study evaluated RFA and EVL for superficial venous insufficiency due to GSV incompetence and compared early and 1-year results Between June 2006 and May 2008 patients with symptomatic primary venous insufficiency due to GSV incompetence were randomized to RFA or EVL Patients with bilateral disease were randomized for treatment of the first leg and received the alternative method on the other Pretreatment examination included a leg assessment using the Venous Clinical Severity Score VCSS and CEAP classification Patients completed the Chronic Venous Insufficiency Questionnaire 2 CIVIQ2 RFA was performed with the ClosurePlus system VNUS Medical Technologies Sunnyvale Calif EVL was performed with the EVLT system AngioDynamics Inc Queensbury NY Early 1-week and 1-month postoperative results of pain bruising erythema and hematoma were recorded Duplex ultrasound DU imaging was used at 1 week and 1 year to evaluate vein status VCSS scores and CEAP clinical class were recorded at each postoperative visit and quality of life QOL using CIVIQ2 was assessed at 1 month and 1 year The study enrolled 118 patients 141 limbs 46 39 were randomized to RFA and 48 40 to EVL and 24 20 had bilateral GSV incompetence At 1 week one patient in the RFA group had an open GSV and was deemed a failure More bruising occurred in the EVL group P 01 at 1 week but at 1 month there was no difference in bruising between groups At 1 year DU imaging showed evidence of recanalization with reflux in 11 RFA and 2 EVL patients P 002 The mean VCSS score change from baseline to 1 week postprocedure was higher for RFA than EVL P 002 but there was no difference between groups at 1 month P 07 and 1 year P 9 Overall QOL mean score improved over time for all patients P 001 CEAP clinical class scores of or 3 were recorded in 21 RFA 44 and 24 EVL patients 44 pretreatment but at 1-year 9 RFA 19 and 12 EVL patients 24 had scores of or 3 P 001 This represented a significant improvement in all patients compared with baseline Both methods of endovenous ablation effectively reduce symptoms of superficial venous insufficiency EVL is associated with greater bruising and discomfort in the perioperative period but may provide a more secure closure over the long-term than RFA

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A randomized, controlled trial of endovenous thermal ablation using the 810-nm wavelength laser and the ClosurePLUS radi...