Risk Factors Associated With Postoperative Complications Following Endovenous Laser Ablation for Varicose Veins

Endovenous laser ablation (EVLA) is a widely accepted treatment for varicose veins, offering effective results with minimal invasiveness. However, postoperative complications remain a concern. This study examines risk factors associated with adverse outcomes and evaluates long-term clinical efficacy over 48 months.

This retrospective, single-center study was conducted from January 2020 to January 2024 and included 500 patients with symptomatic varicose veins due to saphenous vein incompetence. All underwent preoperative clinical and duplex ultrasound evaluation; Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification; and Venous Clinical Severity Score (VCSS) scoring. Patients with postthrombotic syndrome, congenital malformations, or active DVT were excluded. EVLA using a 1470-nm laser was performed by an experienced vascular surgeon. Follow-up visits were scheduled periodically over 48 months. Primary outcomes included postoperative complications, while secondary outcomes focused on VCSS trends and patient satisfaction.

The cohort had a mean age of 38 years and was 56.8% female. Most were CEAP C4 or C5 with Grade 3 venous reflux. Minor complications included hematoma (6.4%), swelling (7.2%), infection (4%), and nerve injury (3.6%). Deep vein thrombosis occurred in 2% of patients; no pulmonary embolism or major cardiac events were reported. Endothermal heat-induced thrombosis occurred in 9%, with only 0.8% reaching Grade 3. Hypertension, diabetes, and obesity were associated with higher complication rates. By 48 months, all patients showed clinical improvement with VCSSs below 5.

EVLA is a safe, effective treatment for varicose veins, even in advanced CEAP stages. Identifying patient-specific risk factors may help reduce complications and improve outcomes.