The effect of endovenous laser ablation on restless legs syndrome

2008 ◽  
Vol 23 (3) ◽  
pp. 112-117 ◽  
Author(s):  
C A Hayes ◽  
J R Kingsley ◽  
K R Hamby ◽  
J Carlow
Keyword(s):  
Laser Ablation ◽  
Restless Legs Syndrome ◽  
Rating Scale ◽  
Varicose Veins ◽  
Complete Relief ◽  
Venous Disease ◽  
Endovenous Laser Ablation ◽  
Restless Legs ◽  
Irls Score

Objectives Venous disease was proposed as a cause of restless legs syndrome (RLS) by Dr Karl A Ekbom in 1944, but has since remained largely unexplored. This study examines the effect of endovenous laser ablation (ELA) in patients with concurrent RLS and duplex-proven superficial venous insufficiency (SVI). Methods Thirty-five patients with moderate to very severe RLS (as defined by the 2003 National Institute of Health (NIH) RLS criteria) and duplex-proven SVI completed an international RLS rating scale questionnaire (IRLS) and underwent standard duplex examination to objectively measure the baseline severity of their conditions. They were separated into non-operative and operative cohorts. The operative cohort underwent ELA of refluxing superficial axial veins using the CoolTouch CTEV 1320 nm laser and ultrasound-guided sclerotherapy of the associated varicose veins with foamed sodium tetradecyl sulphate (STS). All patients then completed a follow-up IRLS questionnaire. Baseline and follow-up IRLS scores were compared. Results Operative correction of the SVI decreased the mean IRLS score by 21.4 points from 26.9 to 5.5, corresponding to an average of 80% improvement in symptoms. A total of 89% of patients enjoyed a decrease in their score of ≥15 points. Fifty-three percent of patients had a follow-up score of ≤5, indicating their symptoms had been largely alleviated and 31% had a follow-up score of zero, indicating a complete relief of RLS symptoms. Conclusions ELA of refluxing axial veins with the CTEV 1320 nm laser and foamed STS sclerotherapy of associated varicosities alleviates RLS symptoms in patients with SVI and moderate to very severe RLS. Recommendations SVI should be ruled-out in all patients with RLS before initiation or continuation of drug therapy.

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.

scholarly journals Endovenous laser ablation for small saphenous varicose veins: Evaluation of outcomes over two year follow-up

2012 ◽  
Vol 10 (8) ◽  
pp. S107-S108
Author(s):  
Nehemiah Samuel ◽  
Tom Wallace ◽  
Rachel Barnes ◽  
Risha Gohil ◽  
Ian Chetter
Keyword(s):  
Laser Ablation ◽  
Varicose Veins ◽  
Endovenous Laser Ablation

scholarly journals DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS

2020 ◽  
Vol 71 (2) ◽  
pp. 457-470
Author(s):  
Mohammed Hatem ◽  
Mahmoud Sobhy ◽  
Wageh Fawzy ◽  
Karem Sabry ◽  
Ahmed Al-Taher
Keyword(s):  
Laser Ablation ◽  
Recurrence Rate ◽  
Lower Limb ◽  
Varicose Veins ◽  
Endovenous Laser Ablation

Endovenous laser ablation of saphenous vein – mid-term results confirm permanent closure and possibility to treat more lesions in one procedure

2020 ◽  
Vol 99 (7) ◽  
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Risk Group ◽  
Varicose Veins ◽  
Outpatient Setting ◽  
Control Group ◽  
Endovenous Laser Ablation ◽  
Postoperative Course ◽  
Mid Term Results

Introduction: Endovenous Laser Ablation (EVLA) is a common alternative to surgical treatment of varicose veins. The aim of our study was to demonstrate that laser occlusion is durable, that we can treat all patients in a one day setting, even with veins >10mm in diameter, and that multiple EVLAs can be done at the same time. Methods: In the period from 1/2017 to 12/2019 EVLA was performed in a total of 1551 consecutive patients with varicose veins and ultrasonographically documented venous reflux. The mid-term results were evaluated in a group of patients operated from 1/2017 to 6/2017 (316 pts.). We compared a risk group that consisted of patients with veins >10mm in diameter (40 pts.) with a control group (the remaining 276 pts.). Patients with veins >10mm are traditionally considered as candidates for conventional surgery. Results: The catheter-based method enabled us to perform more ablations in one procedure. In 2019 we performed 1.44 EVLA procedures per patient. There was only one postoperative follow-up visit, indicating an uncomplicated postoperative course, in 87.5% of patients of the risk group. In the control group 100% of patients had only one follow-up visit including ultrasound examination, showing an uncomplicated postoperative course (p<0.001). There was no difference in the incidence of complications. Ultrasonographic follow-up was performed in the risk group. Veins larger in diameter revealed complete disintegration early, but at the end of the follow-up period (mean 33±6 months) they disappeared completely. Conclusion: The study showed good mid-term results of EVLA of the saphenous vein in the outpatient setting and the feasibility of performing multiple ablations in a non-selected group of patients using local anaesthesia. Laser destruction of the vein was shown to be permanent. Perfect familiarity with the diagnostic procedure using ultrasonography and early patient follow-up are required to achieve reproducibility.

scholarly journals Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study

2016 ◽  
Vol 15 (2) ◽  
pp. 113-119
Author(s):  
Walter Junior Boim de Araujo ◽  
Jorge Rufino Ribas Timi ◽  
Carlos Seme Nejm Junior ◽  
Fabiano Luiz Erzinger ◽  
Filipe Carlos Caron
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Test Group ◽  
Clinical Severity ◽  
Control Group ◽  
Venous Disease ◽  
Endovenous Laser Ablation ◽  
Venous Clinical Severity Score

Abstract Background In endovenous laser ablation (EVLA), the great saphenous vein (GSV) is usually ablated from the knee to the groin, with no treatment of the below-knee segment regardless of its reflux status. However, persistent below-knee GSV reflux appears to be responsible for residual varicosities and symptoms of venous disease. Objectives To evaluate clinical and duplex ultrasound (DUS) outcomes of the below-knee segment of the GSV after above-knee EVLA associated with conventional surgical treatment of varicosities and incompetent perforating veins. Methods Thirty-six patients (59 GSVs) were distributed into 2 groups, a control group (26 GSVs with normal below-knee flow on DUS) and a test group (33 GSVs with below-knee reflux). Above-knee EVLA was performed with a 1470-nm bare-fiber diode laser and supplemented with phlebectomies of varicose tributaries and insufficient perforating-communicating veins through mini-incisions. Follow-up DUS, clinical evaluation using the venous clinical severity score (VCSS), and evaluation of complications were performed at 3-5 days after the procedure and at 1, 6, and 12 months. Results Mean patient age was 45 years, and 31 patients were women (86.12%). VCSS improved in both groups. Most patients in the test group exhibited normalization of reflux, with normal flow at the beginning of follow-up (88.33% of GSVs at 3-5 days and 70% at 1 month). However, in many of these patients reflux eventually returned (56.67% of GSVs at 6 months and 70% at 1 year). Conclusions These data suggest that reflux in the below-knee segment of the GSV was not influenced by the treatment performed.

Endovenous laser ablation of varicose perforating veins with the 1470-nm diode laser using the radial fibre slim

2012 ◽  
Vol 29 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Christof Zerweck ◽  
Eva von Hodenberg ◽  
Matthias Knittel ◽  
Thomas Zeller ◽  
Thomas Schwarz
Keyword(s):  
Laser Ablation ◽  
Diode Laser ◽  
Varicose Veins ◽  
Endovenous Laser Ablation ◽  
Vein Thrombosis ◽  
Perforating Veins ◽  
Superficial Vein Thrombosis ◽  
Radial Fiber ◽  
Perforating Vein

Background Endovenous Laser Ablation (EVLA) is one of the most accepted treatment options for varicose veins. The aim of this study was to investigate the efficacy and safety of the new radial fiber slim (ELVeS-radial-slim kit™) for the 1470 nm diode laser in perforator veins with a 1 month follow-up. Methods Our prospective observational cohort study comprised 69 perforating veins in 55 patients. Ninety percent of all patients were in the CEAP-stage C3-C6. The radial fiber slim was used to occlude the perforating vein and the great or small saphenous vein in the same procedure. The primary efficacy endpoint of the study was ultrasonographically proven elimination of venous reflux in the perforating vein after at least one month. Secondary efficacy and further safety end points after one month were as follows: (1) sonographic exclusion of recanalization of the treated vein segments, (2) deep vein thrombosis (DVT), clinical pulmonary embolism (PE), or superficial vein thrombosis (SVT) as defined by objective testing, (3) death from any cause, (4) persistent clinical complaints such as pain and paresthesia. Results Follow-up could be completed in all patients. In all treated perforating varicose veins, occlusion with elimination of reflux could be demonstrated immediately after the procedure. After one month 95.6% of the treated veins were still occluded (67/69). During follow-up, we did not diagnose any DVT, PE or SVT in the area related to the treated perforating vein. No patient died. One patient reported paresthesia distally of the puncture site. Conclusion Endovenous laser treatment of varicose perforating veins with 1470 nm diode laser using the radial fiber slim is effective and safe with low recanalization rates during 1-month follow-up.

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