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Background: Endovenous laser ablation (EVLA)and radiofrequency ablation(RFA)are both associated with excellent technical, clinical, and patient-reported outcomes for the treatment of varicose veins. Aim: to compare endovenous laser ablation and radiofrequency ablation in the treatment of primary long saphenous varicose veins. Patients and Method: 40 patients scheduled for treatment of varicose veins were included and were divided randomly into 2 equal groups. Endovenous laser ablation was used for the first group and compared to a second group treated with Radiofrequency ablation. The success rate and postoperative results of both groups were compared to each other. Results: closure rate in EVLA group was 100% and in RFA group was 80%, radiofrequency ablation, and EVLA complications: skin burn 5% and 0 %, hyperpigmentation 10% and 0 %, and groin hematoma 0% and 5% respectively. Conclusion: EVLA procedure seems to be superior to RFA in the treatment of long saphenous varicose veins.

Background: Establishing and maintaining vascular access for hemodialysis in end stage renal disease (ESRD) patients are important prognostic factors for patient survival. The loss of vascular access, most frequently due to thrombosis, remains one of the most challenging obstacles in their long-term management. Success rate of surgical intervention of the vascular access in patients with acutely thrombosed arteriovenous fistulas (AVF) is still a controversial issue. Objective: To assess the success rate of salvage of acutely thrombosed arteriovenous fistula through surgical intervention. Patient and Methods: Uncontrolled clinical trial, was conducted over the period from November 2018 to `October 2019 on 52 patients with acute thrombosis of autogenous AVF in Suez Canal University Hospital. Patients were treated using open thrombectomy with or without surgical interventions as jump graft or re-insertion of anastomosis to correct juxta-anastomosis stenosis or re-anastomosis if needed regarding the cause. Results: The mean age was 51 +/-14 years. The cause of thrombosis was stenosis in 13 patients (25%). Surgical intervention was successful to regain immediate functioning AVF in 34 patients (65.4%). The secondary patency rate after intervention was more than 6 months in 29 patients (85.3%). Jump graft with surgical thrombectomy in treatment of stenosis as a cause of thrombosis was the highest rate success in 8 patients (88.9%). Conclusion: Intervention with different surgical modalities for acutely thrombosed AVFs is a safe and effective procedure in many cases. It is associated with good success rates, low complication rates, and maintained long-term patency of vascular access.

Background: New modalities in the Endo Venous Laser Ablation (EVLA) include the new design of the laser catheter tip are claimed to distribute more effectively the laser beam to the targeted varicose vein (VV) wall and therefore to achieve better results and produce less complications. These favorable results support the previously suggested better outcome of the EVLA compared to the open procedure. Aim: This study was conducted to confirm this assumption. Patients and Methods: 81 patients scheduled for treatment of VV were included and were divided into 3 equal groups. EVLA was used with a bare tip fiber for the first group and compared to a second group treated with a radial fiber. Success rate and post-operative results of both groups were compared to each other, then the mean results of EVLA group as a whole was compared to a third control group treated by surgical stripping. Results: There was no statistical significant difference between both EVLA groups. One patient (3.7%), from the bare tip group, had incomplete ablation that necessitated surgical excision. Fewer complications, shorter hospital stay, early return to work and faster reduction in venous clinical severity score (VCSS) were noted among the EVLA compared to the open group. Conclusion: EVLA using bar tip or radial fibers are effective and safe in treating vv with similar results. Their results are as effective as the open procedure with shorter hospital stay, fewer complications and early return to work.

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