Quantitative Evaluation of Peripheral Nerve Injury in Endovenous Laser Ablation with or without Microphlebectomy: Prospective Cohort Study of 25 Cases

Objectives: This study aimed to quantitatively evaluate peripheral nerve injury (PNI) after varicose vein (VV) surgery using endovenous laser ablation (EVLA). Methods: Overall, 25 cases were analyzed. All patients underwent EVLA of the great saphenous vein (GSV) with or without resection of the varix of the GSV tributaries in stab and avulsion fashion (microphlebectomy). For evaluation of PNI, the current perception threshold (CPT) was measured preoperatively at 1 week, 1 month, 3 months, and 6 months postoperatively. In each leg, CPT was measured at 6 points. PNI was defined as >40% elevation from preoperative data. Results: A significant elevation in CPT was observed at 2 points (knee joint level [P = 0.01] and upper portion of the lower leg [P = 0.008]) 1 week postoperatively. CPT decreased after 1 month and recovered to the same level after 6 months. PNI occurred in 52% and 36% of patients at the knee joint level and upper portion of the lower leg, respectively. Microphlebectomy was indicated as a factor associated with PNI (P <0.01). Conclusions: Although VV surgery using EVLA is less invasive, the occurrence of transient PNI in the early postoperative period should be noted when concomitant microphlebectomy is performed.