APPROACHES TO TREATMENT OF RECURRENT VARICOSE VEINS AFTER ENDOVENOUS LASER ABLATION

Abstract

The study aims to study the long-term treatment results of patients with lower limb varicose veins using endovenous laser ablation and to determine the optimal tactics for correction of impaired circulation in different cases of anatomical recurrence. Material and methods. Тhe article presents the treatment results of 464 patients. The average diameter of the saphenofemoral or saphenopopliteal junctions of the operated veins was 0.85 cm. We used a laser with a wavelength of 1 470 nm and a constant speed 0.5 mm/s of automatic reverse traction of the light guide. The follow-up period after the operation was from two to five years. Results. Тhe period of manifestation of a clinical picture of a recurrence of varicose disease on average is 2.3 years (from nine months to four years). The frequency of recurrence of varicose veins is 16%. The main causes of recurrence are technical and tactical errors. The diameter of a vein that we expose to ablation is a significant risk factor for the recurrence of varicose veins (p < 0.001). Clinical recurrence in another venous pool and due to perforating veins occurred in
20 % of cases (with a follow-up period up to five years). The main methods of elimination of pathological venous reflux and varicose veins in the detection of recurrence are laser ablation, foam sclerotherapy, microphlebectomy. The risk of a clinically significant recurrence of varicose disease can be reduced by actively searching for its possible sources in the process of dynamic observation.