Endovenous laser ablation of great saphenous vein (GSV) represents well established technique of radical therapy of varicose veins of lower extremities with excellent long-term results. However, the laser ablation of anterior accessory GSV (AAGSV) remains infrequent in everyday surgical practice. This study assesses the efficacy of this unusual procedure.

From April 2003 to June 2014, we performed endovenous laser ablation of AAGSV in 147 patients (31 men and 116 women). In total, 173 AAGSV procedures were done. Before surgery, all patients were assessed with colour flow duplex ultrasonography and reflux pattern and diameter of the truncal vein (3.5 to 22.8mm) were recorded. The endovenous procedures were performed using 980nm diode or 1320nm Nd:YAG lasers combined with 600 microns bare fiber. In the follow-up (1 month to 10 years postop), patients were asssessed clinically and with duplex ultrasound.

No deep venous thrombosis, nor pulmonary embolism were recorded. In majority of patients, we found bruising and/or indurations along the treated veins which resolved within 2 to 3 weeks. Twice, the neovascularisation was found in the groin and the total occlusion rate was 92%.

Even technically more difficult and delicate, endovenous laser therapy of AAGSV can be performed safely and finally with excellent results comparable to well established ablation of GSV.