• Journal of Chest Surgery
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• v.48 no.5
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• pp.345-350
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• 2015

Background: Conventional stripping is considered to be the standard procedure for great saphenous vein (GSV) varicosities, but many other alternative treatments such as cryostripping, endovenous laser therapy (EVLT), radiofrequency ablation, and ultrasound-guided foam sclerotherapy have been developed. Among them, both cryostripping and laser therapy have been reported to be less traumatic, with lower rates of complications and recurrences when compared to conventional stripping. To compare the efficacy of these treatments, we have analyzed and compared the mid-term clinical outcomes of cryostripping and EVLT. Methods: Patients diagnosed with varicose veins of the GSV and treated with cryostripping or laser therapy between September 2008 and April 2013 were enrolled in this study. Duplex ultrasonography was used for the diagnosis and evaluation of varicosity and reflux, and the clinical-etiology-anatomy-pathophysiology classification was used to measure the clinical severity. The symptoms, Venous Clinical Severity Score (VCSS), recurrence rates, and complication rates of the cryostripping and laser therapy groups were analyzed and compared. Results: A total of 68 patients were enrolled in this study. 32 patients were treated with cryostripping, and 36 patients were treated with laser therapy. The median follow-up period was 29.6 months. Recurrence was noted in three patients from the cryostripping group and in two patients from the EVLT group. There was no difference in the VCSS score, operative time, duration of hospital stay, and complication rate between the cryostripping group and the EVLT group. Conclusion: The mid-term clinical outcomes of cryostripping were not inferior to those of EVLT. Further, considering its cost-effectiveness, cryostripping seems to be a safe and feasible method for the treatment of varicose veins.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.387-393
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• 2010

Background: The aims of the present study were to assess and compare mid-term clinical outcomes including recurrences between endovenous laser therapy (EVLT) and stripping. Material and Method: Between January 2007 and February 2010, 318 limbs in 237 patients with saphenous truncal varicosities were treated by laser energy using a 980 nm diode or were treated with conventional stripping. At the initial visit and at 1, 2, 6, 12, 18, 24, and 36 months postoperatively, clinical examination and questioning for Venous Clinical Severity Score (VCSS) as well as duplex ultrasonography were done. In order to compare clinical outcomes between the two treatment groups, EVLT versus stripping, all data were processed and analyzed. Result: There were no significant differences between the two treatment groups in the extent of the reflux and the number of insufficient perforating veins. The in EVLT and the stripping group at 12 months were $90.3{\pm}4.5%$ and $93.9{\pm}4.2%$, respectively (p>0.05). Total recurrence rates were 4.4% in the EVLT group and 1.5% in the stripping group (p>0.05). In both groups, the VCSS scores were significantly reduced at week 1, 1 month, and 2 months after EVLT or stripping (p<0.001). Conclusion: Efficiency in eliminating truncal saphenous vein incompetence and reducing venous clinical severity were equal in the two treatment groups.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.238-243
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• 2009

Background: Radiofrequency obliteration and endovenous laser therapy of the greater saphenous vein have recently been introduced as alternative, minimally invasive techniques for the treatment of saphenous vein incompetence. The 7 Fr. VNUS $ClosureFAST^{(R)}$ radiofrequency obliteration system was introduced in Gwang-Ju Veterans hospital. The purpose of this study is to evaluate the efficacy and complications of radiofrequency obliteration using the 7 Fr. VNUS $ClosureFAST^{(R)}$ system. Material and Method: Between May 2, 2007 and May 31, 2008, we performed radiofrequency obliteration on 90 patients. The number of males was 67 and their mean age was $57.9{\pm}11.0$ (range: $23{\sim}78$) years old. The patients underwent follow up exams at 3 weeks after the procedures and then every 3 months. The effects of treatment and the complications were reviewed. Result: The postoperative complications were ecchymosis (94.4%), pain (27.8%), paresthesia (25.6%), bullous formation (8.9%), edema (6.7%) and phlebitis (2.2%). One patient showed good blood flow after 3 weeks and one patient showed good blood flow after 3 months. The one-year success rate of radiofrequency obliteration in varicose veins was 97.6%. Conclusion: Our data showed acceptable operative results and short-term clinical results for treating varicose veins with radio frequency obliteration. Long-term follow-up and comparison of radio frequency obliteration with high ligation and stripping, previous radiofrequency ablation and endovenous laser therapy are needed in the future.