Five-Year Results of a Randomized Controlled Trial Comparing High Ligation Combined With Endovenous Laser Ablation and Stripping of the Great Saphenous Vein

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To report 5-year follow-up data of a randomized study comparing high ligation and stripping (HL + S) with high ligation and endovenous laser ablation (HL + EVLA) of the great saphenous vein (GSV).


One hundred patients were randomized. After 5 years, patient satisfaction with the overall result, CEAP-C class, VCSS, CIVIQ2 quality of life score, and recurrence rate were assessed (clinical examination and duplex ultrasound).


Five-year follow-up rates were 83% HL + S and 68% HL + EVLA. Patient satisfaction with the overall result was rated good or very good by 88% after HL + S and 87% after HL + EVLA. There were significant improvements for both groups in CEAP-C class (HL + S 2.28 vs 1.19; HL + EVLA 2.3 vs 1.17), VCSS (HL + S 4.79 vs 1.81; HL + EVLA 4.13 vs 1.87), and CIVIQ2 score (HL + S 82 vs 94; HL + EVLA 75 vs 93) (p < .001). There was no difference in recurrence rates on clinical examination and duplex ultrasound (HL + S 55% vs HL + EVLA 40%; p = .217). A reopened or residual incompetent GSV—partial or complete—was found in 24% (HL + S) and 40% (HL + EVLA), respectively (p = .141).


Varicose vein surgery is followed by favorable clinical results and high patient satisfaction, with no difference between HL + S and HL + EVLA.

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