1. Endo-Venous Laser Therapy vs stripping: A randomized prospective comparison
Nalaka Gunawansa

2. Disclosure
Speaker name: Nalaka Gunawansa
I have the following potential conflicts of interest to report:
Consulting
Employment in industry
Shareholder in a healthcare company
Owner of a healthcare company
Other(s)
I do not have any potential conflict of interest

3. Endo-Venous Laser Therapy (EVLT) Benefits
EVLT is a safe and effective alternative to Surgical Stripping (SS) of the Great Saphenous Vein (GSV) in symptomatic Sapheno-Femoral Incompetence (SFI).
The post-procedure morbidity is minimal
Allows early return to pre-procedure functionality
How does it fare head to head with surgical stripping (SS).

4. Methodology Randomized, prospective case control study
January 2012 through July 2013 – 18 months
EVLT compared to Sapheno-Femoral Ligation and SS
All had duplex confirmed SFI. Recurrent SFI excluded
Day case / <24hr hospital stay
Follow up; 1, 2, 4, 8, 12 weeks and 12 months
Mean follow up 24 (6-80) weeks
Post-procedure pain (visual analog score), wound complications, symptomatic thigh bruising and return to full functionality

5. Results EVLT SFL and SS N=89 138 limbs (49 bilateral, 40 uni)
Local anaesthesia (66)
Spinal anaesthesia (23)
N = 67
102 limbs (35 bilateral, 32 uni)
All under spinal

6. Results EVLT SS p Mean post-procedure pain score at discharge 2
4 (Unilat.), 5 (Bilateral)
0.04
Wound complications
1/138 (<1%)
3/102 (3%)
0.18
Symptomatic thigh bruising
26/138 (19%)
41/102 (40%)
0.021
Time to return to full functionality (unilat.)
2 days
4 days
0.22
Time to return to full functionality (bilat.)
6 days
0.014

7. Conclusion
EVLT is an effective alternative to SFL and SS.
Comparable short and medium term efficacy
Significantly fewer post-procedure pain and morbidity.
The return to full pre-procedural functionality is significantly quicker, especially after bilateral procedures.
Longer follow up required to assess recurrence.