Endovenous laser ablation for persistent and recurrent venous ulcers after varicose vein surgery

2008 ◽  
Vol 23 (4) ◽  
pp. 193-195 ◽  
Author(s):  
A A Kambal ◽  
H D De'Ath ◽  
H Albon ◽  
A Watson ◽  
A Shandall ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Varicose Vein ◽  
Complete Healing ◽  
Effective Intervention ◽  
Varicose Vein Surgery ◽  
Endovenous Laser Ablation ◽  
The Past ◽  
Compression Bandaging ◽  
Venous Ulcers ◽  
Saphenous Veins

A 75-year-old woman presented with painful recurrent venous ulcers (VU) continuously for the past 33 months on a background of frequent intermittent problems for the last 16 years. She had previously been treated with varicose vein surgery and trials of compression bandaging. Subsequently, she underwent endovenous laser ablation (EVLA) targeting the distal incompetent remnant of her great and small saphenous veins. This resulted in complete healing of her ulcers within four weeks. The dramatic response demonstrated in this case suggests that EVLA may represent an effective intervention in the management of postsurgery refractory VU.

Varicose Vein Surgery

2011 ◽  
Author(s):  
Jovan N. Markovic ◽  
Cynthia K. Shortell
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Great Saphenous Vein ◽  
Significant Proportion ◽  
The United States ◽  
Clinical Severity ◽  
Treatment Modalities ◽  
Venous Disease ◽  
Varicose Vein Surgery

Chronic venous insufficiency (CVI) is a common vascular disorder that affects a significant proportion of the population in the United States and other developed countries. In its advanced stages, CVI significantly reduces patients’ quality of life and imposes a high economic burden on society due to increased direct health care costs and reduced productivity. Favorable clinical results associated with endovascular ablation techniques and patient preference for minimally invasive procedures has led to a shift in which treatment of vein disease is moving from the hospital to the office, allowing a more diverse group of physicians to enter a field that had typically been the domain of surgeons. This chapter reviews the terminology associated with venous disease, indications for varicose vein surgery, preoperative evaluation, procedural planning, endovenous procedures (endovenous laser ablation, radiofrequency ablation), surgical vein stripping techniques, and foam sclerotherapy. Tables include Clinical severity, Etiology or Cause, Anatomy, Pathophysiology classification; summary of nomenclature changes for the lower extremity venous system; indications for varicose vein surgery; interrogation points in the venous reflux examination; complications associated with treatment modalities used in the management of CVI; and methods of variceal ablation. Figures show an ultrasonographic image of a saphenous eye, placement of a quartz fiber for laser ablation of the great saphenous vein, a typical saphenofemoral junction, surgical stripping  of the great saphenous vein, and microfoam sclerotherapy. This review contains 9 figures, 6 tables and 73 references.

To Study the Role of Skin Grafting and Superficial Varicose Vein Surgery Simultaneously In Treatment of Venous Ulcers

2018 ◽  
Vol 9 (3) ◽  
pp. 291-295
Author(s):  
Teli Bhavuray ◽  
◽  
Mundada Ashishkumar B. ◽  
Avula Sreekant ◽  
Ganeshan Karthick ◽  
...  
Keyword(s):  
Varicose Vein ◽  
Skin Grafting ◽  
Varicose Vein Surgery ◽  
Venous Ulcers

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.

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.

Saphenous nerve injury after endovenous laser ablation of incompetent greater saphenous vein: An electroneuromyography study

2015 ◽  
Vol 31 (2) ◽  
pp. 106-110 ◽  
Author(s):  
S Yilmaz ◽  
O Delikan ◽  
E Aksoy
Keyword(s):  
Laser Ablation ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Sensory Nerve ◽  
Saphenous Nerve ◽  
Sensory Nerve Action Potential ◽  
Endovenous Laser Ablation ◽  
Saphenous Veins ◽  
Sensory Nerve Action ◽  
Saphenous Nerve Injury

Aim To determine whether endovenous laser ablation of incompetent greater saphenous vein causes a detectable impairment in saphenous nerve conduction. Material and methods Thirty-five patients (mean age: 44.78 ± 8.6, male/female ratio: 16/19) who were operated on for incompetent greater saphenous veins, underwent electroneuromyography before and two weeks after the operation. Dysesthesia was questioned as to whether having unpleasant abnormal sensation after the operation. Positive electroneuromyography findings for saphenous nerve injury included a sensory nerve action potential amplitude <2 µV or a nerve conduction velocity <48.0 m/s or a latency onset >5.0 ms. Results Thirty-four patients were available at two-week follow-up. All patients achieved complete proximal closure. Three patients (8.8%) had dysesthesia at two weeks. Mean electroneuromyography values were not significantly different between preoperative and postoperative period. Postoperatively, none of the patients had abnormal sensory nerve action potential or latency onset, whereas nerve conduction velocity decreased below the lower limit in two patients. These two patients were not among those having dysesthesia and they had no other complaints. Conclusion Injury to saphenous nerve seems not likely during endovenous laser ablation of incompetent greater saphenous veins, as evidenced by normal electroneuromyography values found after the operation.

Endovenous laser ablation in patients with wide diameter of the proximal segment of the great saphenous vein: Comparison of methods

2014 ◽  
Vol 30 (10) ◽  
pp. 700-705 ◽  
Author(s):  
V Starodubtsev ◽  
M Lukyanenko ◽  
A Karpenko ◽  
P Ignatenko
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Chronic Venous Disease ◽  
Proximal Segment ◽  
Venous Disease ◽  
Endovenous Laser Ablation ◽  
Safety And Efficacy ◽  
Wide Diameter ◽  
Saphenous Veins

Objective To estimate the safety and efficacy of using the laser 1560 nm wavelength for treatment of chronic venous disease in patients with wide diameters of the proximal segment of the great saphenous vein. Methods In the study 88 patients with lower limb varicose veins were included. Maximum diameter of the great saphenous vein proximal segment varied from 15 to 34 mm (22 ± 2.3) in all patients. In the 1st group in 34 cases crossektomy and endovenous laser ablation (EVLA) were performed. In the 2nd group in 30 cases EVLA regardless diameter of the great saphenous vein proximal segment was performed. In the 3rd group in 34 cases EVLA taking into account the diameter of the great saphenous vein proximal segment was performed. The laser 1560 nm wavelength was used. Linear endovenous energy density in the 1st and 2nd groups was 90 J/cm for the proximal segment and trunk of great saphenous vein. Linear endovenous energy density in the 3rd group was personalized on the size of the veins: 100 J/cm for diameter of great saphenous vein proximal segment 15–20 mm, 150 J/cm for diameter 20–30 mm, 90 J/cm for middle and distal segments of great saphenous vein. Results In the 1st group obliteration of the trunk of the great saphenous veins and accessory great saphenous veins in all cases without additional interventions was reached. In the 2nd group at four cases (13.3%) the second procedure EVLA was carried out, after which the obliteration of the trunk was achieved. In the 3rd group the obliteration of the trunk of great saphenous vein was achieved without additional interventions. Conclusion Our experience of using the laser 1560 nm wavelength for the treatment of the chronic venous disease in patients with wide diameter of the proximal segment of great saphenous vein shows the safety and efficacy of this technique. EVLA has to be personalized on the size of the segments of vein in patients with wide proximal segment of great saphenous vein.

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