Technical Efficacy and Safety of Outpatient Endovenous Laser Ablation of Varicose Veins Under Local Anesthesia

Abstract

Background: Endovenous Laser Ablation (EVLA) is the recommended method for treating varicose veins. It is commonly performed in an inpatient or as day surgery setting under either general or spinal anesthesia. The purpose of this study is to assess the technical efficacy and safety performing outpatient EVLA for varicose veins under local tumescent anesthesia for procedure success, complications, recovery time, and patient satisfaction. Methods: A retrospective review of 300 consecutive patients who underwent outpatient EVLA under local tumescent anesthesia from October 2014 to June 2019 was undertaken. Patients 25–55 years diagnosed with symptomatic varicose veins and Great Saphenous Vein (GSV) incompetence were enrolled. Patient demographics, clinical characteristics, procedure duration, complications, and follow-up outcomes were recorded. Results: A total of 331 limbs were treated. The mean procedure time was 36 minutes. Five procedures were aborted for technical reasons, resulting in an overall technical success rate of 98%. They were minor complications of bruising (13%) and phlebitis (5%), that were resolved and did not require further intervention. There were no significant complications, including deep vein thrombosis (DVT) or pulmonary embolism (PE). Patients were discharged and resumed normal activities within approximately seven days and were well satisfied. Conclusion: EVLA for varicose veins can be performed as an outpatient procedure under local tumescent anesthesia safely and with high technical efficiency. It offers the benefits of shorter recovery times, less risk of complications, and lower health care costs.