Angela A. Kokkosis1* and Harry Schanzer2
1Department of Vascular Surgery, Stony Brook University Medical Center, USA
2Department of Vascular Surgery, Mount Sinai Medical Center, USA
Objective: Compression therapy is routinely used after endovenous saphenous ablation therapy (EVA) for the treatment of varicose veins. The rationale for compression therapy is enhancement of vein closure and prevention of superficial thrombophlebitis (STP) and deep thrombophlebitis (DVT). A very common patient complaint postoperatively is the discomfort elicited by the compression. The present work aims to determine whether compression therapy is necessary as an adjunct to EVA.Methods: A total of 108 consecutive lower extremities in 96 patients were treated with EVA. Fortynine of the treated extremities had postoperative compression, 59 did not. All patients had duplex evaluation at one week following EVA and then were clinically evaluated at one and three months. Primary end points were status of the treated vein, presence or absence of STP or deep venous thrombosis, and degree of varicose vein resolution.Results: There was no difference between compression and no-compression groups in sex (68.8% vs. 67.3% female), age (59 vs. 56), CEAP class (C2-C3, 88% vs. 92%; C4-C5, 12% vs. 8%), extent and size of varicose veins (Classes I-II: <6 mm diameter, 57% vs. 66%; Classes III-IV: >6 mm diameter, 43% vs. 34%), type of vein treated ( GSV 84% vs. 71% , SSV 8% vs. 17%, accessory 8% vs. 12%) and operative variables. There was a 96% follow-up rate at 1 week, 4 saphenous veins in the compression group remained open (p=0.0395). Three patients in the compression group and 0 patients in the no-compression group had STP. One patient in the compression group had thrombus extension up to the saphenofemoral junction. At one month both groups had the same rate of varicose vein regression and need for secondary procedures.Conclusion: Compression therapy does not add any further benefit to EVA and therefore consideration should be given to eliminating it, thus simplifying and improving the postoperative recovery.
Compression therapy; Varicose veins; Chronic venous disease; EVLT; Endovenous ablation
Kokkosis AA, Schanzer H. Compression Therapy may not be Necessary after Endovenous Ablation Therapy for the Treatment of Varicose Veins. Clin Surg. 2017; 2: 1700.