August 4, 2025

Comparative Clinical and Patient-Reported Outcomes for Endovenous Laser Ablation vs. Cyanoacrylate Ablation in Chronic Venous Insufficiency: A Systematic Review and Meta-Analysis

Key Points

EVLA achieved an occlusion rate of 92.85%, while CAA had 87.27% after 12 months.
Both treatments resulted in similar improvements in venous clinical severity scores (VCSS).
Nine studies contributed to the final analysis, evaluating effectiveness and safety of both procedures.
Results indicate EVLA has a higher rate of adverse events compared to CAA, despite similar effectiveness in quality of life.

Abstract

The approach treatments to manage Chronic Venous Insufficiency (CVI) has evolved from surgery to minimally invasive techniques such as Endovenous Thermal Ablation (EVLA) with complications persist. The literature search was performed through databases including PubMed, Scopus, ProQuest, and ScienceDirect up to April 2025. The primary outcome was oclussion rates in 12 months. Other outcomes included Venous Clinical Severity Score (VCSS) improvement and adverse events. Nine studies were included as final data analysis. The occlusion rates for CVI after EVLA and CAA of 92.85% and 87.27%, respectively. After 12 months follow-up, both groups showed similar improvement in Venous Clinical Severity Scores (VCSS). Overall, adverse events were more common with EVLA, while the CAA group had lower rates. Both EVLA and CAA procedures demonstrated high occlusion rates. The improvement in quality of life after both EVLA and CAA procedure is similar. However, EVLA has more complications than CAA while maintaining similar effectiveness.

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