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. 2010 Apr 1;10(6):1–92.

Table A8: Clinical Trials Involving Endovascular Laser Ablation vs. Surgical Treatment for VV.

      Endovascular Laser Surgical Arm  
Author, Year, Country Trial Design, Sample Setting, Operator, Anesthesia Laser λ, Power Mode, Energy (J/cm) Concurrent or Staged Procedures Surgical Technique Concurrent or Staged Procedures Follow-Up
Darwood
2006
UK		 3-arm RCT

118 p
(57%F)

  • Outpatient clinic

  • Vascular surgeons

  • Local tumescent anesthesia (ELT) vs. day case general anesthetic (surgery)

 810nm

Arm 1: 12W power on pulse mode with pullback rate 2-3 mm/sec with 60.9 J/cm (49.2-68.8)

Arm 2: 14 W continuous mode withdraw rate 2-3 mm/sec with 71.1 J/cm (64.7-80.6)		 Staged sclerotherapy at 6 wks for residual varices if requested by patient Arm 3. High ligation SFJ and inversion stripping GSV to the knee Concurrent multiple phlebectomies 12 month
DeMedeiros
2005
Brazil		 2-arm within person RCT,

20 p
(95% F)

  • Vascular surgery clinic

  • Vascular surgeons

  • Epidural block (ELT) and subarachnoid (60%)/ epidural block (surgery)

 810nm

12-14 W on pulsed mode		 Concurrent high ligation GSV and all tributaries, mini phlebectomies and ligation insufficient perforator veins High ligation GSV and forward total stripping GSV to the ankle Concurrent mini phlebectomies and ligation all GSV tributaries and insufficient perforator varices 9 month (range: 2-18)
Disselhoff
2008, 2009
Netherlands		 2-arm RCT + CE study

120 p
(69% F)

  • Outpatient (ELT), day case (surgery)

  • Surgeon doing surgery and ELT

  • Patient choice anesthesia – tumescent anesthetic

 810nm

14 W continuous pulse mode

57 (41-86) J/cm		 Staged 6-wk post-op sclerotherapy or phlebectomy for persistent varices Ligation and liquid cryosurgery stripping and avulsion of tributaries Staged at 6-wk post-op sclerotherapy or phlebectomy for persistent varices 2 year
Kalteis
2008
Austria		 2-arm RCT

100 p
(75% F)

  • Outpatient clinic

  • >1 surgeon ( >50 vein surgeries / yr)

  • No tumescent anesthesia

 810nm

Variable watts declining down leg (10-12W, 6 W, 4-6W)

Targeted energy level 20-30 J/cm		 Concurrent high ligation of GSV and ligation of all side tributaries followed by ELT. and stab avulsions of all side tributaries Dissection SFJ junction, high ligation of GSV, ligation of all side tributaries followed by GSV stripping Concurrent stab avulsions of all marked tributaries 4 week
Rasmusson
2007, 2009
Denmark		 2-arm RCT + costing study

121 p
(69% F)

  • Outpatient setting for ELT and surgery

  • 2 experienced surgeons (>100 ELT)

  • Tumescent anesthesia

 980nm

12 W pulse mode

mean delivered energy 73.5 J/cm (range 57 – 95.4)		 Concurrent all varices removed by miniphlebectomies High ligation and perforate invagination stripping of GSV Concurrent all varices removed by miniphlebectomies 6 month 2 year
Theivacumar
2009
UK		 2-arm mixed RCT

127 p
(68 randomized)

(61% F)

  • Outpatient clinic

  • Vascular surgeon

  • All treatments general anesthesia

 810nm

12 W pulse mode		 Staged within 12 wks foam sclerotherapy of residual varicoses SFJ ligation and division of all tributaries with GSV stripping to the knee Concurrent multiple stab avulsions of varices 2 year
*

RCT refers to randomized controlled trial; GSV, great saphenous vein; SFJ, saphenofemoral junction