Hybrid endovenous laser ablation reduces the recurrence of varicose veins below the knee compared with radiofrequency ablation: a real-world study

INTRODUCTION: This study aimed to investigate the outcome of hybrid endovenous laser ablation (EVLA, 1470 nm) and radiofrequency ablation (RFA) procedures for varicose veins (VVs). MATERIAL AND METHODS: We retrospectively analysed the clinical data of patients from July 2019 to December 2020. Eighty-four patients (121 limbs) underwent a hybrid EVLA procedure, and 108 patients (151 limbs) underwent an RFA procedure. The outcomes, venous clinical severity score (VCSS), chronic venous disease quality-of-life questionnaire (CIVIQ-20) score, and recurrence at 1, 6, and 12 months were collected. RESULTS: No differences in complications or 24-h pain scores were noted between the 2 procedures, but a lower dosage of foam sclerosant was used in the EVLA procedure than in the RFA procedure (p < 0.02). The postoperative VCSS and CIVIQ-20 scores in the 2 groups were significantly decreased compared with the scores before the procedure, and no differences in scores were noted between the 2 procedures at 1 month. However, the VCSS and CIVIQ-20 scores for the EVLA procedure were significantly better than those for the RFA procedure at 6 and 12 months (p < 0.05). Both procedures showed a similar great saphenous vein closure rate at 12 months. The EVLA procedure showed lower rates of overall recurrence (4.96% vs. 14.57%, OR = 3.27, 95% CI: 1.33–8.00, p = 0.01) and recurrence below the knee (4.13% vs. 11.92%, OR = 3.14; 95% CI: 1.18–8.35, p = 0.02). Moreover, the patient satisfaction score was greater for the EVLA procedure than for the RFA procedure (p < 0.02). CONCLUSIONS: The hybrid EVLA (1470 nm) procedure reduces VV recurrence below the knee and results in better quality-of-life scores.