Recurrence patterns after endovenous laser treatment of saphenous vein reflux

2016 ◽  
Vol 31 (7) ◽  
pp. 496-500 ◽  
Author(s):  
Ronald S Winokur ◽  
Neil M Khilnani ◽  
Robert J Min
Keyword(s):  
Laser Ablation ◽  
Varicose Veins ◽  
Endovenous Laser Ablation ◽  
Recurrent Varicose Veins ◽  
Saphenous Veins ◽  
Recurrence Patterns ◽  
Endovenous Laser Treatment ◽  
Saphenofemoral Junction ◽  
Patterns Of Recurrence

Introduction The patterns of recurrent varicose veins after endovascular ablation of the saphenous veins are not well described. Methods The current study describes the ultrasound defined recurrence patterns seen in 58 patients (79 limbs) who returned for evaluation of recurrent varicose veins from a cohort of 802 patients treated with endovenous laser ablation and subsequent sclerotherapy from March 2000 to March 2007 with clinical follow-up until May 2014. Findings The most common ultrasound defined recurrence patterns leading to the varicose veins were new reflux in the anterior accessory saphenous and small saphenous veins as well as recanalization of the treated saphenous segment. Neovascularization at the saphenofemoral junction and incompetent perforating veins as the source of the recurrent veins were not seen. Conclusions The patterns of recurrence following thermal ablation of saphenous veins are different to those seen after surgery. Specifically, new reflux in other saphenous veins is responsible for most recurrent varicose veins and neovascularity seems to be unusual following endovenous laser ablation.

Endovenous laser ablation of great saphenous veins using a 1470 nm diode laser and the radial fibre – follow-up after six months

2010 ◽  
Vol 26 (1) ◽  
pp. 35-39 ◽  
Author(s):  
F Pannier ◽  
E Rabe ◽  
J Rits ◽  
A Kadiss ◽  
U Maurins
Keyword(s):  
Laser Ablation ◽  
Diode Laser ◽  
Laser Energy ◽  
Varicose Veins ◽  
Compression Stockings ◽  
Efficient Treatment ◽  
Endovenous Laser Ablation ◽  
Saphenous Veins ◽  
Bare Fibre

Background Endovenous laser ablation (EVLA) is an efficient method to treat insufficient great saphenous veins (GSV) with high occlusion rates.1–5 Most studies used 810, 940 or 980 nm diode lasers and a bare fibre.1,2,6 Moderate postoperative pain and bruising are frequent findings.2,6 Laser systems with higher wavelengths like 1470 nm with a higher absorption in water show less pain and bruising after the procedure.7–9 A newly-developed fibre (radial fibre, Biolitec) emits the laser energy radially around the tip directly into the venous wall contrary to the bare fibre.9 The aim of this study was to demonstrate the outcome and side-effects after EVLA of GSV with a 1470 nm diode laser (Ceralas E, Biolitec) by using the radial fibre. Methods Non-randomized, prospective study including 50 unselected limbs of 50 patients with a duplex sonographically verified incompetent GSV. EVLA was performed with a 1470 nm diode laser (Ceralas E, Biolitec) and a radial fibre. In the same session all insufficient tributaries were treated by phlebectomy. Tumescent local anaesthesia with 0.05% lidocaine was applied perivenously. Laser treatment was carried out in a continuous mode with a power of 15 W. Compression stockings (30 mmHg) were applied for one month. Postinterventional checkups took place one, 10, 30 days and six months after the procedure. Results Three patients were lost to follow-up. The average linear endovenous energy density (LEED) was 90.8 J/cm vein (SD 35.3). At the six month follow-up all treated veins remained occluded and no new reflux in the treated segments occurred. No recurrent varicose veins had occurred so far. No severe complications such as deep venous thrombosis could be detected. In four patients at 30 days and three patients at six months local paresthesia occurred in the region of EVLA. Forty-four percent of patients did not have any pain after the treatment and 50% did not take any analgesic tablets at any time after the procedure. Postoperative ecchymoses in the track of the treated GSV was rare. In 80% of the limbs, no ecchymoses was observed after the treatment. Conclusion EVLA of GSV with a radially emitting laser fibre by using a 1470 nm diode laser is a safe and efficient treatment option.

Endovenous laser ablation of the great saphenous vein – Varying energy may not affect outcome

2016 ◽  
Vol 32 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Carlos S Nejm ◽  
Jorge RR Timi ◽  
Walter Boim de Araújo ◽  
Filipe C Caron
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Endovenous Laser Ablation ◽  
Vein Occlusion ◽  
Saphenous Veins ◽  
Occlusion Rate

Objectives To determine great saphenous vein occlusion rate after endovenous laser ablation using the 1470-nm bare-fiber diode laser to supply either 7 W or 15 W and evaluate procedure-related complications. Method Patients with varicose veins of the lower extremities (CEAP class C2–C6) were randomly assigned to undergo either 7-W (18 patients, 30 limbs) or 15-W (18 patients, 30 limbs) endovenous laser ablation. Duplex ultrasound follow-up was at 3–5 days, 1, 6, and 12 months postoperatively. Results Occlusion rate was 100% in both groups at 3–5 days and 1 month and 86.7% in 7-W and 100% in 15-W patients at both 6 and 12 months, with no difference between groups ( p > 0.05). Four (13.3%) 15-W and 3 (10%) 7-W patients had paresthesia at 3–5 days, with no difference between groups ( p > 0.05). Conclusions These preliminary data suggest that both techniques are similarly effective in the treatment of varicose great saphenous veins.

Conventional surgery and endovenous laser ablation of recurrent varicose veins of the small saphenous vein: a retrospective clinical comparison and assessment of patient satisfaction

2010 ◽  
Vol 25 (3) ◽  
pp. 151-157 ◽  
Author(s):  
L van Groenendael ◽  
L Flinkenflögel ◽  
J A van der Vliet ◽  
E A Roovers ◽  
S M M van Sterkenburg ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Laser Ablation ◽  
Saphenous Vein ◽  
Sural Nerve ◽  
Varicose Veins ◽  
Treatment Modalities ◽  
Complication Rates ◽  
Endovenous Laser Ablation ◽  
Recurrent Varicose Veins

Objectives Recurrences of varicosities of the small saphenous vein (SSV) are common. Surgical reintervention is associated with increased complication rates. The aim of the study was to assess the feasibility of endovenous laser ablation (EVLA) in recurrent varicose veins of the SSV and to compare this technique with surgical reintervention. Methods All case files of patients treated for SSV varicosities between May 2006 and October 2008 were evaluated and recurrences were selected. Demographics, duplex findings, clinical, aetiological, anatomical and pathological classification, perioperative and follow-up data were all registered. Additionally, a questionnaire focusing on patient satisfaction was taken. Results Two hundred and eighty-one patients were treated for varicosities of the SSV, of which 42 were for recurrences. Twenty-six of these were treated with EVLA, all under local anaesthesia, and 16 were surgically treated. Most surgically treated patients were treated under regional anaesthesia (88%). Technical success was achieved in 94% of surgically treated patients and in all EVLA-treated patients. Complications in both groups were mostly minor and self-limiting. Sural nerve neuralgia appeared to be more frequent in the surgically treated group (20% versus 9%). After correction for length of follow-up, the incidence of rerecurrences was not statistically significant between groups. Conclusion EVLA is feasible in patients with recurrent varicose veins of the SSV with possibly a lower incidence of sural nerve injury. Patient satisfaction is high for both treatment modalities. Studies with larger samples are indicated to confirm these observations.

scholarly journals Comparison of Short-Term Outcomes Between Endovenous 1,940-nm Laser Ablation and Radiofrequency Ablation for Incompetent Saphenous Veins

2020 ◽  
Vol 7 ◽  
Author(s):  
Insoo Park ◽  
Sun-Cheol Park
Keyword(s):  
Radiofrequency Ablation ◽  
Laser Ablation ◽  
Varicose Veins ◽  
Normal Activity ◽  
Short Term ◽  
Closure Rate ◽  
Pain Scores ◽  
Saphenous Veins ◽  
Lower Pain

Background: Radiofrequency ablation (RFA) has shown faster recovery and lower pain scores compared to Endovenous laser ablation (EVLA) for treatment of varicose veins. However, a comparison of 1,940-nm EVLA and RFA has not been reported. This study compared short-term outcomes using 1,940-nm EVLA and RFA for varicose veins.Methods: Between April 2018 and June 2018, 43 patients (83 incompetent saphenous veins) were treated with 1,940-nm EVLA and 37 patients (64 incompetent saphenous veins) with RFA. Follow-up duplex was checked at 1 month and 3 months.Results: Baseline characteristics showed no significant differences between both groups except for age. Pain scores at 6 h, and at 1, 10, and 30 days after treatment showed no differences. Complications and time to return to normal activity showed no differences. The 100% closure rate was checked in both groups at 1 month and 3 months follow-up.Conclusion: Short-term outcomes showed no significant differences between 1,940-nm EVLA and RFA treatment.

A description of the ‘smile sign’ and multi-pass technique for endovenous laser ablation of large diameter great saphenous veins

2017 ◽  
Vol 33 (8) ◽  
pp. 534-539 ◽  
Author(s):  
Emma B Dabbs ◽  
Laurensius E Mainsiouw ◽  
Judith M Holdstock ◽  
Barrie A Price ◽  
Mark S Whiteley
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Large Diameter ◽  
Diameter Distribution ◽  
Short Term ◽  
Endovenous Laser Ablation ◽  
Saphenous Veins ◽  
Vein Diameter

Aims To report on great saphenous vein diameter distribution of patients undergoing endovenous laser ablation for lower limb varicose veins and the ablation technique for large diameter veins. Methods We collected retrospective data of 1929 (943 left leg and 986 right leg) clinically incompetent great saphenous vein diameters treated with endovenous laser ablation over five years and six months. The technical success of procedure, complications and occlusion rate at short-term follow-up are reported. Upon compression, larger diameter veins may constrict asymmetrically rather than concentrically around the laser fibre (the ‘smile sign’), requiring multiple passes of the laser into each dilated segment to achieve complete ablation. Results Of 1929 great saphenous veins, 334 (17.31%) had a diameter equal to or over 15 mm, which has been recommended as the upper limit for endovenous laser ablation by some clinicians. All were successfully treated and occluded upon short-term follow-up. Conclusion We suggest that incompetent great saphenous veins that need treatment can always be treated with endovenous laser ablation, and open surgery should never be recommended on vein diameter alone.

scholarly journals Treatment of recurrent varicose veins of the great saphenous vein by conventional surgery and endovenous laser ablation

2009 ◽  
Vol 50 (5) ◽  
pp. 1106-1113 ◽  
Author(s):  
Laura van Groenendael ◽  
J. Adam van der Vliet ◽  
Lizel Flinkenflögel ◽  
Elisabeth A. Roovers ◽  
Steven M.M. van Sterkenburg ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Conventional Surgery ◽  
Endovenous Laser Ablation ◽  
Recurrent Varicose Veins
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