Current clinical evidence on endovenous laser ablation (EVLA) from randomised trials

K. Rass

doi:10.12687/phleb2317-4-2016

Phlebologie, Table of Contents

Phlebologie 2016; 45(04): 201-206
DOI: 10.12687/phleb2317-4-2016

Systematic Review

Schattauer GmbH

Aktuelle klinische Evidenz zur endovenösen Laserablation (EVLA) aus randomisierten Studien

Article in several languages: English | deutsch

Authors

K. Rass

¹Vein and Skin Center, Eifelklinik St. Brigida, Simmerath/Germany

Abstract

Zusammenfassung

Hintergrund Die Entwicklung der endovenöse Laserablation (EVLA) insuffizienter Stammvenen hat sich bisher in drei Schritten vollzogen: EVLA #1 (810-980 nm), EVLA #2 (1064-1500 nm) und EVLA #3– optimierte Laseremission (Radialfaser, Tulip, Jacket-Tip). Angesichts der Vielzahl der Verfahren stellt sich die Frage nach dem Stellenwert im Vergleich zu Crossektomie und Stripping (C/S) und anderen endovenösen Therapien.

Methoden PubMed Recherche zum Vergleich von EVLA mit C/S, Radiofrequenzablation (RFA), Schaumsklerotherapie, Dampfablation in randomisierten Studien (RCT).

Ergebnisse Es wurden 24 RCTs identifiziert: n=15 beinhalten Vergleiche mit C/S, n=9 mit anderen Verfahren. Langzeit-Studien (n=6) weisen auf eine Überlegenheit von C/S bzgl. klinischer und duplexsonographischer Rezidive hin. 15 Studien berichten über kurzfristige Ergebnisse, die eine Unterlegenheit der EVLA #1 gegenüber EVLA #2, EVLA #3 und RFA belegen.

Schlussfolgerungen Laser der 1. Generation sind bzgl. Nebenwirkungen und Langzeitwirksamkeit anderen Therapieverfahren unterlegen. Angesichts der jüngsten Publikationen sollte C/S weiterhin als Kontrollarm in RCTs, die die Wertigkeit der EVLA untersuchen, fungieren.

Schlüsselwörter

Endovenöse Laserablation - Evidenz - randomisierte kontrollierte Studien

Full Text

References

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