Endovenous Laser Ablation - Myths unraveled

The aim of this thesis was to unravel some enduring myths of EVLA, regarding mechanisms of action, in vitro effects, efficacy and patient reported outcomes.
In order to do so, we first summarized the technically known working mechanisms of EVLA in a review, along with additional explanatory optical-thermal mathematical models (chapter 2).
Secondly, we created temperature profiles of different EVLA devices and settings, EVSA and RFA, with in vitro experiments (chapter 3), to give more insight in what happens in the veins when the EVTA device is switched on during treatment.
Thirdly, we investigated the efficacy and patient reported outcomes of EVLA versus the newest form of EVTA, EVSA, in the first RCT with EVSA worldwide (chapter 4).
Fourthly, we examined the difference in patient reported outcomes between short (Hb-target) and long (water-target) EVLA wavelengths in the first RCT on this topic, in order to investigate the deeply rooted, but never properly studied assumption that longer wavelengths are more patient-friendly (chapter 5).
Finally, a meta-analysis of only EVLA efficacy was performed to summarize the overall efficacy, but also to differentiate between efficacy in different EVLA settings (energy), wavelengths, outcome definitions and follow-up duration (chapter 6).