Combination technique of tumescent anesthesia during endovenous laser therapy of saphenous vein insufficiency☆

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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Natural History of the Great Saphenous Vein Stump Following Endovenous Laser Therapy

Vascular and Endovascular Surgery ◽

10.1177/1538574408316139 ◽

2008 ◽

Vol 42 (4) ◽

pp. 348-351 ◽

Cited By ~ 8

Author(s):

Irina Pleister ◽

Julie Evans ◽

Patrick S. Vaccaro ◽

Bhagwan Satiani

Keyword(s):

Natural History ◽

Laser Therapy ◽

Saphenous Vein ◽

Great Saphenous Vein ◽

Endovenous Laser Therapy ◽

History Of

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A randomized study comparing conventional surgery versus endovenous laser therapy for the treatment of primary varicose veins of the long saphenous vein

Benha Medical Journal ◽

10.4103/bmfj.bmfj_126_18 ◽

2018 ◽

Vol 35 (3) ◽

pp. 442

Author(s):

BishoyE Luiz ◽

AhmedS Ezzat ◽

AtefA.G Salem ◽

HusseinG El-Gohary

Keyword(s):

Laser Therapy ◽

Saphenous Vein ◽

Varicose Veins ◽

Randomized Study ◽

Conventional Surgery ◽

Long Saphenous Vein ◽

Endovenous Laser Therapy ◽

Primary Varicose Veins

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A new percutaneous technique: N-butyl cyanoacrylate adhesive for the treatment of giant saphenous vein insufficiency

Vascular ◽

10.1177/1708538117724647 ◽

2017 ◽

Vol 26 (2) ◽

pp. 194-197 ◽

Cited By ~ 4

Author(s):

Mehmet Senel Bademci ◽

Kaptanıderya Tayfur ◽

Gökhan Ocakoglu ◽

Serkan Yazman ◽

Muhammet Akyüz ◽

...

Keyword(s):

Saphenous Vein ◽

Varicose Vein ◽

Severity Score ◽

Early Period ◽

Duplex Ultrasound ◽

Clinical Severity ◽

Tumescent Anesthesia ◽

Clinical Severity Score ◽

Venous Clinical Severity Score ◽

Vein Insufficiency

Background We have made a retrospective evaluation of the results of the cyanoacrylate ablation technique which has recently started to be used in the treatment of giant saphenous vein insufficiency today and in which tumescent anesthesia is not required. Methods Giant saphenous vein was treated in 50 patients between September 2015 and September 2016 by using endovenous cyanoacrylate ablation. In the procedure, tumescent anesthesia and varsity socks were not used. Control duplex ultrasound evaluation was performed in the post-procedural 1st, 6th and 12th months. Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire scores were evaluated. Results In the 50 patients who were treated, full closure was observed in giant saphenous vein in 47 (94%) patients in the 12th month control duplex ultrasound. The mean age of the patients was 46.4 (20–70) and 30 (60%) of them were female. The median Venous Clinical Severity Score scores in the 1st, 6th and 12th months were 3, 2 and 1, respectively ( p < 0.001); the median Aberdeen Varicose Vein Questionnaire scores in the 1st, 6th and 12th months were 7, 5 and 4, respectively ( p < 0.001). In the access site, two (4%) patients developed phlebitis and one (2%) developed ecchymosis. However, deep venous thrombosis, pulmonary embolism and paresthesia were not observed. Conclusion Considering the early period results in the treatment of giant saphenous vein insufficiency, cyanoacrylate ablation makes a more reliable alternative than endovenous thermal ablation methods in that it does not require tumescent anesthesia and it has a low incidence of adverse effects.

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The anatomical relationship between the saphenous nerve and the great saphenous vein

Phlebology The Journal of Venous Disease ◽

10.1258/phleb.2010.010011 ◽

2011 ◽

Vol 26 (3) ◽

pp. 114-118 ◽

Cited By ~ 5

Author(s):

L Veverková ◽

V Jedlička ◽

P Vlček ◽

J Kalač

Keyword(s):

Radiofrequency Ablation ◽

Laser Therapy ◽

Histological Examination ◽

Saphenous Vein ◽

Varicose Vein ◽

Great Saphenous Vein ◽

Lower Leg ◽

Saphenous Nerve ◽

Endovenous Laser Therapy ◽

Anatomical Relationship

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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