Melani Limenco Benly

University of Indonesia
Indonesia

Abstract Title: Endovenous Laser Ablation for Giacomini Vein Insufficiency: An Underexplored yet Promising Therapeutic Option? A Meta-Analysis

Biography: Melani is an MD who completed her studies at Tarumanagara University, and has been a research assistant at the National Cardiovascular Center in Indonesia in the Vascular division. She has worked in both central and periphery health care centers and has published several papers in both international and nationally acclaimed journals. She also has several presented abstracts accepted in international congresses and national symposiums.

Research Interest: Background: Giacomini vein insufficiency (GVI) presents significant diagnostic and therapeutic challenges due to its anatomical complexity and proximity to critical neurovascular structures. Despite its relevance, there are no treatment guidelines for GVI. This study aims to evaluate the efficacy and safety of Endovenous Laser Ablation (EVLA) in GVI, to propose a standardized treatment protocol for GVI. Method: A systematic review and meta-analysis of four databases were conducted. Given its novelty, data conversions from median to mean were needed. The pooled mean differences (MD) with 95% confidence intervals (CI) were analyzed using a random-effects model. Heterogeneity was assessed with the I² statistic and Cochrane’s Q test. Risk of Bias (RoB) was evaluated using the ROBINS-I tool. Result: Six studies involving 121 patients were included. EVLA significantly improved Revised Venous Clinical Severity Scores (rVCSS) (pooled MD: 4.51; 95% CI: 3.79–5.22; p<0.00001, I²=0%) and CEAP classification scores (pooled MD: 1.10; 95% CI: 0.36–1.83; p=0.003, I²=75%). No major complications were reported, underscoring EVLA’s favorable safety profile. Discussion: Our findings are consistent with previous studies on endovenous treatments. The absence of major complications and substantial clinical improvement in both rVCSS and CEAP suggest EVLA's efficacy and promising safety in GVI. However, past studies did not isolate the Giacomini vein and compared multiple modalities, highlighting the need for further research. Conclusion: EVLA is an effective and promising option for GVI, with significant clinical improvements and low complication rates. Future studies should focus on long-term outcomes and comparative trials to establish standardized treatment protocols.