Endovenous laser ablation for saphenous vein insufficiency: long-term results
To present the long-term results of our 158 endovenous laser ablation (EVLA) procedures. Materials and methods: From June 2008 to December 2011, 158 patients (89 women, 69 men; mean age: 38.2 years, range: 27-65) were treated with EVLA for venous insufficiency in 192 lower limbs. All patients were symptomatic and the majority had a class 4 or higher clinical disease (CEAP classification). A 980-nm diode laser was used under general anesthesia combined with local tumescent anesthesia to deliver 100 to 140 laser applications along the course of the vein. Compression bandages were applied for 2 weeks postoperatively. Follow-up exams were done by Doppler ultrasound exam at 4 weeks, 6 months, 1 year, and 2 years. Results: A total of 192 great saphenous veins were ablated, achieving a 99% clinical success rate. Postoperative complications were mild and well tolerated. Of the 2 (1.0%) recanalized target veins, 2 were successfully treated with a second EVLA procedure. After 3 to 6 months of EVLA treatment, 99% of the patients had significant relief of their symptoms. All patients returned to normal activity within 2 days. Conclusion: EVLA for symptomatic saphenous vein incompetence is a minimally invasive and successful technique in resolving varicose veins and reducing symptoms.
Endovenous laser ablation for saphenous vein insufficiency: long-term results
To present the long-term results of our 158 endovenous laser ablation (EVLA) procedures. Materials and methods: From June 2008 to December 2011, 158 patients (89 women, 69 men; mean age: 38.2 years, range: 27-65) were treated with EVLA for venous insufficiency in 192 lower limbs. All patients were symptomatic and the majority had a class 4 or higher clinical disease (CEAP classification). A 980-nm diode laser was used under general anesthesia combined with local tumescent anesthesia to deliver 100 to 140 laser applications along the course of the vein. Compression bandages were applied for 2 weeks postoperatively. Follow-up exams were done by Doppler ultrasound exam at 4 weeks, 6 months, 1 year, and 2 years. Results: A total of 192 great saphenous veins were ablated, achieving a 99% clinical success rate. Postoperative complications were mild and well tolerated. Of the 2 (1.0%) recanalized target veins, 2 were successfully treated with a second EVLA procedure. After 3 to 6 months of EVLA treatment, 99% of the patients had significant relief of their symptoms. All patients returned to normal activity within 2 days. Conclusion: EVLA for symptomatic saphenous vein incompetence is a minimally invasive and successful technique in resolving varicose veins and reducing symptoms.
___
- Min RJ, Zimmet SE, Isaacs MN. Endovenous laser treatment of the incompetent greater saphenous vein. J Vasc Interv Radiol 2001; 12: 1167–71.
- Teruya TH, Ballard JL. New approaches for the treatment of varicose veins. Surg Clin North Am 2004; 84: 1397–417.
- Wagner WH, Levin PM, Cossman V, Lauterbach SR, Cohen JL, Farber A. Early experience with radiofrequency ablation of the greater saphenous vein. Ann Vasc Surg. 2004; 18: 42–7.
- Dietzek AM. Endovenous radiofrequency ablation for treatment of varicose veins. Vascular 2007; 15: 255–61.
- Ünlü Y, Karapolat S, Erkut B. Multiple aneurysms of the left external jugular vein. Turk J Med Sci 2005; 35: 43–5.
- Min RJ, Khilnani NM. Endovenous laser ablation of varicose veins. J Cardiovasc Surg 2005; 46: 395–405.
- Merchant RF, Pichot O. Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency. Vasc Surgery 2005; 42: 502–
- Almeida JA, Kaufman JA. Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study. JVIR 2009; 20: 752–9.
- Timperman PE, Sichlau M, Ryu RK. Greater energy delivery improves treatment success of endovenous laser treatment of incompetent saphenous veins. J Vasc Interv Radiol 2004; 15: 1061–3.
- Dexter D, Kabnick L, Berland T, Jacobowitz G. Complications of endovenous laser. Phlebology 2012; 27 (Suppl 1): 40–5.