<![CDATA[Background: In chronic venous insufficiency (CVI), a puncture below the knee is done to access the great saphenous vein for endovenous laser ablation (EVLA). Getting a puncture below the knee is difficult in some conditions. Puncture above the knee to access the incompetent saphenous vein is another option. Objective: This study compared CVI patients' clinical results after EVLA with above- and below-the-knee punctures.Methods/Design: This retrospective, single-centre cohort study compared clinical outcomes after two EVLA technical punctures. Puncturing the GSV below the knee was one way. An above-knee GSV puncture was chosen as an alternative. At all follow-up visits, clinical outcomes, closure rate, and complications such as thrombosis, bruising, burn damage, and paresthesia were assessed. Results: This study has recruited 248 patients, with 132 patients in the below-knee group and 116 patients in the above-knee group. Similar clinical outcomes after the procedure with the Venous Clinical Severity Score (VCSS) were seen in both groups (p = 0.875) and with the Venous Disability Score (VDS) were seen in both groups (p = 0.777) without significant difference. The closure rate in both groups was 100%. Complications, including thrombosis, did not show statistical significance between groups (p = 1.000). Bruising, burn injuries, and paresthesia were absent in both groups.Conclusion: The EVLA for incompetence GSV using an above-knee puncture was safe and effective and should be considered as an alternative method if the below-knee puncture fails.]]>
