| Problem: Chronic venous insufficiency is present in over one-third of the American population. Of those 35% percent, 4% have active venous stasis ulcerations, which have burdened the healthcare system significantly. Endovenous laser ablation (EVLA), a minimally invasive procedure, has become the gold standard in treating venous insufficiency. After patients undergo EVLA there can be post procedure complications. A long-term complication is the risk of recanalization, or reopening of the ablated vein, most often seen within the first two years post procedure. There has been data to suggest that positioning may have a role in decreasing the rate of recannulization. The mechanism may be related to decreasing the amount of intraluminal blood remaining in the great or small saphenous vein. Methods: Peer-reviewed articles within the last decade identified that positioning had an overall effect on the recannulization rate. Results: The majority were studies that revealed that if the amount of intraluminal blood was decreased there could be an overall decreased rate of recannulization. Conclusion: Further research on the influence of patient positioning, more specifically Trendelenberg versus reverse Trendelenberg, on the overall outcome in endovenous laser ablation is needed. This research will likely show a decreased rate of recannulization correlated with the Trendelenberg position. |
