Potential complications include phlebitis, new telangiectasias, and residual pigmentations. Exceedingly rare complications include DVT [7]. Other nontumescent techniques that are used are cyanoacrylate glue. Risk factors would be allergies to adhesives. Multiple studies have shown that, compared with conventional open surgery and EVLA, chemical sclerotherapy has worse outcomes at 1-, 5-, and 8-year follow-ups, with higher rates of recurrent GSV reflux and saphenofemoral junction failure [33-36]. There are conflicting data on QoL, however, with equivalent improvement reported per the Aberdeen Varicose Vein Severity Score [36] and inferior improvement reported per the Chronic Venous Insufficiency Quality of Life Questionnaire [35]. Ligation and Stripping Higher rates of GSV reflux recurrence are identified with EVLA compared with high ligation and stripping. Both EVLA and high ligation and stripping, however, were noted to have similar metrics on disease specific QoL [37- 39]. Another study comparing high ligation and stripping versus EVLA in patients with GSV incompetence showed no significant difference between the 2 groups in recurrent GSV reflux, recurrent varicose veins, frequency of reoperations, Venous Clinical Severity Score, and QoL scores in a 5-year follow-up [40]. The RELACS study demonstrated, specifically, that high ligation and stripping was superior to EVLA in recurrence rates 5 years post- treatment [38]. There are conflicting data regarding procedural complications. Pan et al [24] affirms that there is no significant difference in postprocedural phlebitis and bruising and concludes that there are fewer complications regarding bleeding, hematoma, wound infection, and paresthesia with EVLA. Rass et al [39], on the other hand, affirms that higher rates of phlebitis, tightness, and dyspigmentation were noted with EVLA. Microphlebectomy Microphlebectomy involves the surgical excision of pathologic vessels.
Lower Extremity Chronic Venous Disease. Potential complications include phlebitis, new telangiectasias, and residual pigmentations. Exceedingly rare complications include DVT [7]. Other nontumescent techniques that are used are cyanoacrylate glue. Risk factors would be allergies to adhesives. Multiple studies have shown that, compared with conventional open surgery and EVLA, chemical sclerotherapy has worse outcomes at 1-, 5-, and 8-year follow-ups, with higher rates of recurrent GSV reflux and saphenofemoral junction failure [33-36]. There are conflicting data on QoL, however, with equivalent improvement reported per the Aberdeen Varicose Vein Severity Score [36] and inferior improvement reported per the Chronic Venous Insufficiency Quality of Life Questionnaire [35]. Ligation and Stripping Higher rates of GSV reflux recurrence are identified with EVLA compared with high ligation and stripping. Both EVLA and high ligation and stripping, however, were noted to have similar metrics on disease specific QoL [37- 39]. Another study comparing high ligation and stripping versus EVLA in patients with GSV incompetence showed no significant difference between the 2 groups in recurrent GSV reflux, recurrent varicose veins, frequency of reoperations, Venous Clinical Severity Score, and QoL scores in a 5-year follow-up [40]. The RELACS study demonstrated, specifically, that high ligation and stripping was superior to EVLA in recurrence rates 5 years post- treatment [38]. There are conflicting data regarding procedural complications. Pan et al [24] affirms that there is no significant difference in postprocedural phlebitis and bruising and concludes that there are fewer complications regarding bleeding, hematoma, wound infection, and paresthesia with EVLA. Rass et al [39], on the other hand, affirms that higher rates of phlebitis, tightness, and dyspigmentation were noted with EVLA. Microphlebectomy Microphlebectomy involves the surgical excision of pathologic vessels.