Role of Endovenous Laser Therapy in Management of Chronic Venous Ulcers. Running title: Endovenous Laser Therapy for Chronic Venous Ulcers

Background: Chronic venous ulcers represent the major issue of morbidity in the world, and recurrence rates of ulcers remain high under compression treatment. Endovenous laser therapy (EVLT) has emerged as a less invasive approach to treating venous reflux, and it is superior to conventional surgery. However, there is a lack of data on tertiary-care centres in India. Material and Methods: Our study was conducted at a tertiary-care hospital in India from January 2023 to June 2024 as a retrospective observational study. The number of patients was 70. The medical records of patients with chronic venous ulcers treated with EVLT were reviewed. Demographic data, CEAP categorisation, ulcer size, healing period, recurrence rate, complications, and adherence to compression data were examined. The main outcome was the time to ulcer healing; recurrence and complications were secondary outcomes. Results: Of course, the healing period for the ulcer was six weeks. Sixty per cent of patients were cured completely, and ten per cent relapsed—90 per cent at three months. The complications were mild, including pain, superficial infection, and thrombophlebitis. The best predictor of slow healing was the ulcer size; the age was of little significance, and the CEAP classification had little effect. Patients who had excellent compliance with compression therapy had lower recurrence rates. Conclusion: EVLT is a safe and effective modality in managing chronic venous ulcers in Indian tertiary care hospitals, with prompt healing, reduced recurrence and few complications. The size of UL and the compliance related to compression have a strong impact. The use of EVLT and adjunct compression at an early stage can optimise the use of ulcer in the resource-constrained setting. Keywords: Endovenous Laser Therapy, Chronic Venous Ulcer, Varicose Veins, Venous Insufficiency, Compression Therapy, Minimally Invasive Surgery.