Comparative Efficacy of Postoperative Compression Methods After EVLT for Great Saphenous Vein Insufficiency

Niki Tadayon; Mostafa Mousavizadeh; Fateme Yousefimoghaddam; Faezeh Jadidian; Mohammadmoein Mirhosseini; Naser Hadavand

doi:10.34172/jlms.2024.02

Comparative Efficacy of Postoperative Compression Methods After EVLT for Great Saphenous Vein Insufficiency

J Lasers Med Sci. 2024 Feb 28:15:e2. doi: 10.34172/jlms.2024.02. eCollection 2024.

Authors

Niki Tadayon¹, Mostafa Mousavizadeh¹, Fateme Yousefimoghaddam², Faezeh Jadidian³, Mohammadmoein Mirhosseini⁴, Naser Hadavand⁵

Affiliations

¹ General and Vascular Surgery Ward, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
² Research fellow, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
³ School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Laser Application in Medical Sciences Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
⁵ Rajaie Cardiovascular Medical and Research Institute, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: The preference for endovascular techniques in treating varicose veins, particularly in the great saphenous vein (GSV), has increased due to their minimally invasive nature and reduced complications. Post-operative care, especially involving compression therapy, remains crucial to improve outcomes, prevent varicose vein recurrence, and enhance overall recovery. This study aimed to evaluate the efficacy of eccentric compression therapy compared to alternative post-operative care methods following endovenous laser treatment (EVLT) for GSV insufficiency. Methods: This prospective randomized clinical trial encompassed 88 EVLT procedures for GSV insufficiency. The participants were divided into two groups, each receiving different postoperative compression methods, and were evaluated over a specified period. The primary outcome was the pain scale after EVLT; meanwhile, the secondary outcome measured in the present study was the rate of GSV occlusion after EVLT. Results: Both groups underwent all EVLT procedures successfully without any complications. At the one-month duplex ultrasound (DUS) follow-up, the sapheno-femoral junction occlusion rates were 97% (43 out of 44) for group A (eccentric compression plus gradual compression stocking) and 95% (42 out of 44) for group B (only gradual compression stocking). Ecchymosis was observed in only 12 patients across both groups, accounting for an overall occurrence of 13.6%. Group A patients reported significantly lower analgesic usage (10%) compared to group B (18%), although this difference did not reach statistical significance. Analysis of postoperative pain data utilizing the visual analog scale (VAS) showed a median value of 5.5 in group B patients, which decreased to 3.1 with the application of eccentric compression. Moreover, there was less ecchymosis in group A observed by one week. Conclusion: This study contributes to the ongoing discourse on the efficacy of postoperative compression in varicose vein treatment. It underscores the necessity for more comprehensive, well-designed studies to yield clearer conclusions and provide better guidance for post-procedure care.

Keywords: Compression stocking; Eccentric compression therapy; Endovenous laser treatment (EVLT); Pain; VAS; Varicose vein.