Retrograde Endovenous Laser Therapy Facilitates Great Saphenous Vein Closure in the Setting of Severe Vasospasm

Objective Damage to the saphenous nerve (SN) has been a known complication during varicose vein surgeries. We tested whether a better knowledge of the anatomy of the SN and the great saphenous vein (GSV) can prevent such damage. Methods We conducted a morphological and histological examination on 86 limbs from 43 cadavers in order to analyse the anatomical interrelation between the SN and the GSV in the lower leg and we also measured the distance between the nerve and the vein in a sample of 42 sections from three parts of the lower leg. Results The anatomical relationship between the SN and the GSV is varied and the two structures run close to each other so a better knowledge of their anatomy in itself proved insufficient in preventing damage to the SN. Conclusion However, in the case of endovenous laser therapy and radiofrequency ablation tumescent anaesthesia decreases the risk of damage to the SN.

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Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: Analysis of early efficacy and complications

Journal of Vascular Surgery ◽

10.1016/j.jvs.2005.05.014 ◽

2005 ◽

Vol 42 (3) ◽

pp. 488-493 ◽

Cited By ~ 212

Author(s):

Alessandra Puggioni ◽

Manju Kalra ◽

Michele Carmo ◽

Geza Mozes ◽

Peter Gloviczki

Keyword(s):

Radiofrequency Ablation ◽

Laser Therapy ◽

Saphenous Vein ◽

Great Saphenous Vein ◽

Endovenous Laser Therapy

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Ablation of the great saphenous vein with nontumescent n-butyl cyanoacrylate versus endovenous laser therapy

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2016.09.007 ◽

2017 ◽

Vol 5 (2) ◽

pp. 210-215 ◽

Cited By ~ 28

Author(s):

İsmail Koramaz ◽

Helin El Kılıç ◽

Fatih Gökalp ◽

Macit Bitargil ◽

Nilüfer Bektaş ◽

...

Keyword(s):

Laser Therapy ◽

Saphenous Vein ◽

Great Saphenous Vein ◽

Endovenous Laser Therapy

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Endovenous Laser Therapy of Great Saphenous Veın: Six Months Follow-Up

Anatomy & Physiology ◽

10.4172/2161-0940.1000152 ◽

2014 ◽

Vol 04 (04) ◽

Author(s):

Celalettin Karatepe

Keyword(s):

Laser Therapy ◽

Saphenous Vein ◽

Great Saphenous Vein ◽

Endovenous Laser Therapy

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Determination of a Safe Target Zone for the Use of Endovenous Laser Therapy of the Small Saphenous Vein

Journal for Vascular Ultrasound ◽

10.1177/154431670703100205 ◽

2007 ◽

Vol 31 (2) ◽

pp. 93-95

Author(s):

Xiu-Jie Wang ◽

Theresa Impeduglia ◽

Steve Elias

Keyword(s):

Laser Therapy ◽

Saphenous Vein ◽

Laser Energy ◽

Clinical Signs ◽

Intraoperative Ultrasound ◽

Retrospective Chart Review ◽

Target Distance ◽

Starting Point ◽

Endovenous Laser Therapy ◽

Tumescent Solution

Background and Purpose This study was designed to determine a safe target distance (TD) from the saphenopopliteal junction (SPJ) to initiate endovenous laser therapy (EVLT). Methods A retrospective chart review was performed. Thirty-six limbs in 33 patients were treated with EVLT for small saphenous vein (SSV) incompetence. An 810-nm diode laser at 12W in the continuous mode was used. Clinical assessment was performed 1 week postoperatively and duplex scanning within 30 days. Results Mean vein diameter was 7.1 mm (max, 11 mm). The distance between the EVLT starting point and the SPJ ranged from 1.5 to 3.5 cm (mean, 2.19cm). Closure of the SSV was confirmed by completion ultrasonography in all cases. Twenty of 33 patients had 1 month follow-up scanning. None had SSV recanalization, deep venous thrombosis, adverse reactions to the laser, or clinical signs of nerve injury. Closure was noted 0.5–1 cm proximal to the initial target distance fiber location at the onset of EVLT ranging from 1 to 1.5 cm from the SPJ. Conclusion We propose a minimal 2 cm distance from the SPJ and a 2 cm radius of tumescent solution to counteract the perivenous effects of the laser energy. Anatomic morphology and these calculated distances determined by intraoperative ultrasound guidance are critical to the safe outcome of EVLT of the SSV.

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