J Vasc Surg Venous Lymphat Disord. 2026 Aug 29:102607. doi: 10.1016/j.jvsv.2026.102607. Online ahead of print.
ABSTRACT
BACKGROUND: Giacomini vein (GV) incompetence is an uncommon cause of chronic venous disease, and evidence regarding its endovenous treatment remains limited. This study evaluated the clinical and duplex ultrasound outcomes of endovenous laser ablation (EVLA) in patients with incompetent GV.
METHODS: This prospective single-center study included 83 limbs in 75 consecutive patients treated with EVLA for symptomatic GV incompetence between January 2018 and January 2024. Diagnosis and reflux assessments were performed using duplex ultrasonography. Clinical severity was classified according to the CEAP classification, while clinical outcomes and quality of life were assessed using the Venous Clinical Severity Score (VCSS) and the VEINES-QOL questionnaire. The primary outcome was complete vein occlusion. Secondary outcomes included technical success, symptom improvement, recanalization, and complications. Follow-up was performed at 1, 6, and 12 months, and annually thereafter.
RESULTS: Technical success and immediate post-procedural occlusion were achieved in all treated limbs (100%). The mean follow-up period was 28.3 ± 16.3 months. The overall occlusion rate at the latest follow-up was 96.4% (80/83 limbs). Partial and complete recanalization occurred in two (2.4%) and one (1.2%) limbs, respectively. Mean VCSS significantly improved from 6.9 ± 1.4 at baseline to 2.1 ± 1.4 at 12 months, while mean VEINES-QOL score increased from 50.4 ± 4.8 to 78.7 ± 6.1 (both p < .001). No major complications, including deep vein thrombosis, pulmonary embolism, or endothermal heat-induced thrombosis, were observed. Kaplan-Meier estimated freedom from recanalization was 95.6% at 48 months.
CONCLUSIONS: In this prospective single-center cohort, EVLA of the incompetent GV was associated with high technical success, durable occlusion, clinical improvement, and a low complication rate. Further comparative studies are needed to define its role relative to other endovenous treatment modalities.
PMID:42668115 | DOI:10.1016/j.jvsv.2026.102607