Purpose of Technology: The goal of endovenous laser ablation (EVLA) is to use laser energy to seal off the damaged portions of varicose veins, prevent further varicose vein formation, eliminate associated discomfort, and improve cosmetic appearance. This therapy is intended primarily for the treatment of varicose veins that result from great saphenous vein (GSV), small saphenous vein (SSV), or saphenofemoral junction (SFJ) reflux.
Rationale: Compared with conventional vein stripping or ligation procedures, EVLA may reduce postoperative morbidity, as well as shorten recovery time.
Controversy: There is a need to compare alternative treatments with conventional surgery with respect to rates of retreatment and patient-centered outcomes. Factors such as contraindications for EVLA (e.g., extremely tortuous veins that do not allow for passage of the catheter) may influence decisions about treatment. Relative costs, patient preference, and patient selection criteria are also contextual factors of interest to payers, providers, and patients.
Relevant Questions:
- Among patients being treated for varicose veins, what is the clinical effectiveness of endovascular laser ablation (EVLA) compared with ligation with or without stripping?
- Among patients being treated for varicose veins, what are the harms associated with endovascular laser ablation (EVLA) compared with ligation with or without stripping?
- Have definitive patient selection criteria been established for the use of endovascular laser ablation (EVLA) in patients with symptomatic varicose veins?
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