Correlation Between Diameter and Occlusion Rate of Great Saphenous Vein on Revised Venous Clinical Severity Score after Endovenous Laser Ablation in Chronic Venous Insufficiency Patients

Background: The effectiveness of endovenous laser ablation (EVLA) on the diameter of the large saphenous vein is still widely debated, as the larger diameter of the saphenous vein has a lower occlusion rate after EVLA and can affect the Revised Venous Clinical Severity Score (r-VCSS) value. This study aims to determine the relationship between the diameter and occlusion rate of the great saphenous vein (GSV) post-EVLA. Methods: This study was a cross-sectional design of patients with chronic venous insufficiency in the GSV who underwent EVLA. Thirty-seven extremities from 34 patients underwent a 1,470-nm EVLA with a radial tip. The diameter of the GSV was measured using Doppler ultrasound in 4 segments (3 femoral, 1 cruris), and pre-EVLA r-VCSS was also assessed. One week after EVLA, GSV occlusion was assessed using Doppler ultrasound and r-VCSS values. Results: Per observations, 13.5% of cases failed occlusion 1 week post-EVLA. All occlusion failures occurred at the one-third proximal of the femoral segment (diameter >10 mm) (P < 0.05). There was no significant difference between occlusion rates with r-VCSS, comparing pre-EVLA and post-EVLA (P = 0.490 and P = 0.102). The difference in diameter according to the cut value does not affect the r-VCSS after the procedure. Conclusion: Pre-EVLA vein diameter influences the success of post-EVLA occlusion. The degree of GSV occlusion does not affect the r-VCSS after EVLA.