Intravenous Catheter-Guided Laser Ablation: A Novel Alternative for Branch Varicose Veins

Abstract It is difficult to manage tributary varicose veins with endovenous laser ablation. Using the intravenous catheter-guided laser fiber to ablate the tributary varicose veins has been proposed. From April 2004 to December 2009, we randomly assigned 134 patients with 170 limbs for laser therapy, of which, 89 limbs in 74 patients were treated with laser ablation. The residual tortuous veins were abolished with the intravenous catheter-guided laser ablation (ICLA group), whereas residual varicose veins in 81 limbs in 60 patients were treated by stab avulsion (SA group). Patients were followed up with the median of 44.5 months after surgery. The outcomes and durability of treatment in both groups were evaluated. The primary end point was recurrence of varicose veins. In comparison with the SA group, patients in the ICLA group had fewer surgical incisions and morbidity, a shorter hospital stay, and returned to normal activity earlier. The overall 5-year recurrence of varicose veins was infrequent in the ICLA group but was much higher in the SA group (5.4% versus 20%, P = 0.022). ICLA provided better outcomes than conventional SA in managing the branched varicose veins and may be an alternative for the treatment of branch varicose veins.

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Laser fiber migration into the pelvic cavity: A rare complication of endovenous laser ablation

Phlebology The Journal of Venous Disease ◽

10.1177/0268355514541982 ◽

2014 ◽

Vol 30 (9) ◽

pp. 641-643 ◽

Cited By ~ 2

Author(s):

Yu Lun ◽

Shikai Shen ◽

Xiaoyu Wu ◽

Han Jiang ◽

Shijie Xin ◽

...

Keyword(s):

Laser Ablation ◽

Side Effects ◽

Surgical Procedure ◽

Varicose Veins ◽

Rare Complication ◽

Pelvic Cavity ◽

Severe Damage ◽

Endovenous Laser Ablation ◽

Laser Fiber

Endovenous laser ablation is an established alternative to surgery with stripping for the treatment of varicose veins. Ecchymoses and pain are frequently reported side effects of endovenous laser ablation. Device-related complications are rare but serious. We describe here an exceptional complication, necessitating an additional surgical procedure to remove a segment of laser fiber that had migrated into the pelvic cavity. Fortunately, severe damage had not occurred. This case highlights the importance of checking the completeness of the guidewire, catheter, and laser fiber after endovenous laser ablation.

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The Endovenous Laser Therapy for the Management of Varicose Veins

Birat Journal of Health Sciences ◽

10.3126/bjhs.v3i2.20941 ◽

2018 ◽

Vol 3 (2) ◽

pp. 437-442

Author(s):

Prashant Kaushal ◽

Shen Xuan San

Keyword(s):

Hospital Stay ◽

Laser Therapy ◽

Varicose Veins ◽

Invasive Procedure ◽

Normal Activity ◽

Minimally Invasive Procedure ◽

Operative Blood Loss ◽

Duration Of Hospital Stay ◽

Endovenous Laser Therapy ◽

The Mean

Introduction: Varicose veins of the lower limb are common condition affecting majority of people worldwide and has great effect on quality of life. The definitive therapy being surgery with stripping of the veins which is associated with surgical complications, prolong recovery time and significant recurrence. Endovenous laser therapy (EVLT) is a minimally invasive procedure which is widely used for the treatment of varicose veins with excellent results.Objective: To evaluate the safety and efficacy of EVLT for the management of varicose veins.Methodology: This was a prospective study of 40 patients who underwent endovenous laser therapy at the affiliated hospital of Inner Mongolia University for the Nationalities from October 2016 to September 2017. All patients with primary symptomatic varicose veins with sapheno-femoral incompetence or great saphenous vein (GSV) reflux were included in the study. The patient's information and data were recorded during the hospital stay in the proforma for EVLT with the informed consent. The variables used were mean operating time, intra-operative blood loss, duration of hospital stay, return to normal activity, complications and the recanalization. Following discharge, the patients were followed up to six months.Results: Forty patients with unilateral varicose veins were treated with EVLT. There were 24 female and 16 male with mean age of 52 yrs and the majority of patients having symptoms for more than five years. The mean operative time and intra-operative blood loss were 80 minutes and 52 ml respectively. The mean duration of hospital stay was 2.5 days with 90% patients returning to the normal activity in 10 days. Swelling and indurations were the most common complication in 10 patients followed by hypoesthesia in 8, ecchymosis in 7 and skin burn in 4 patients.Conclusion: EVLT seems to be safe and effective minimally invasive procedure with excellent clinical outcome in terms of lower postoperative pain, early return to normal activities and fewer complications. However large sample size with long follow up study should be conducted for evaluating long term benefits. BJHS 2018;3(2)6:437-442.

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Retained Foreign Body After Laser Ablation

International Surgery ◽

10.9738/cc155.1 ◽

2013 ◽

Vol 97 (4) ◽

pp. 293-295 ◽

Cited By ~ 2

Author(s):

Shiyan Ren ◽

Peng Liu ◽

Wei Wang ◽

Yuguan Yang

Keyword(s):

Laser Ablation ◽

Foreign Body ◽

Postoperative Complications ◽

Laser Therapy ◽

Varicose Veins ◽

Warning Signal ◽

Retained Foreign Body ◽

Preventive Approach ◽

Laser Fiber

Abstract Laser ablation for varicose veins is a common practice, and postoperative complications may happen. A retained foreign body could be left accidently in the treated leg. It is rarely reported in literature. We herein describe two cases of retained foreign body during the laser ablation for varicose veins. One patient with varicose veins received laser therapy 5 years earlier, and had experienced discomfort and pain. After investigation, an overlooked sheath fragment was removed surgically from the leg. Another patient with varicose veins had discomfort after laser ablation for 8 days, and has been asymptomatic after the removal of the retained foreign body in the leg. The essential preventive approach include to pinpoint the site of the tip of fiberoptic laser fiber and pull 1 to 2 cm of the sheath out of the patient, then withdrawal the fiberoptic fiber and sheath simultaneously. A white flash light in the trunk of the fiberoptic laser fiber is an important warning signal of an erroneous manipulation during the operation. The surgeon should routinely check the intact sheath and fiberoptic fiber after laser ablation. In conclusion, retained foreign body can be prevented by following some practical tips during laser ablation.

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Complications and Failure of Endovenous Laser Ablation and Radiofrequency Ablation Procedures in Patients With Lower Extremity Varicose Veins in a 5-Year Follow-Up

Vascular and Endovascular Surgery ◽

10.1177/1538574416671247 ◽

2016 ◽

Vol 50 (7) ◽

pp. 475-483 ◽

Cited By ~ 13

Author(s):

Witold Woźniak ◽

R. Krzysztof Mlosek ◽

Piotr Ciostek

Keyword(s):

Radiofrequency Ablation ◽

Laser Ablation ◽

Lower Extremity ◽

Varicose Veins ◽

Endovenous Laser Ablation

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Endovenous laser ablation of varicose veins with the 1470-nm diode laser

Journal of Vascular Surgery ◽

10.1016/j.jvs.2010.01.027 ◽

2010 ◽

Vol 51 (6) ◽

pp. 1474-1478 ◽

Cited By ~ 89

Author(s):

Thomas Schwarz ◽

Eva von Hodenberg ◽

Christian Furtwängler ◽

Aljoscha Rastan ◽

Thomas Zeller ◽

...

Keyword(s):

Laser Ablation ◽

Diode Laser ◽

Varicose Veins ◽

Endovenous Laser Ablation

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Randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins

British Journal of Surgery ◽

10.1002/bjs.7394 ◽

2011 ◽

Vol 98 (4) ◽

pp. 501-510 ◽

Cited By ~ 99

Author(s):

D. Carradice ◽

A. I. Mekako ◽

F. A. K. Mazari ◽

N. Samuel ◽

J. Hatfield ◽

...

Keyword(s):

Clinical Trial ◽

Laser Ablation ◽

Randomized Clinical Trial ◽

Varicose Veins ◽

Conventional Surgery ◽

Endovenous Laser Ablation

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Heat conduction from the exceedingly hot fiber tip contributes to the endovenous laser ablation of varicose veins

Lasers in Medical Science ◽

10.1007/s10103-008-0639-y ◽

2009 ◽

Vol 24 (2) ◽

pp. 247-251 ◽

Cited By ~ 31

Author(s):

Renate R. van den Bos ◽

Michael A. Kockaert ◽

H. A. Martino Neumann ◽

Rolf H. Bremmer ◽

Tamar Nijsten ◽

...

Keyword(s):

Heat Conduction ◽

Laser Ablation ◽

Varicose Veins ◽

Endovenous Laser Ablation

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

Frontiers in Surgery ◽

10.3389/fsurg.2020.620034 ◽

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.

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Successful lysis in a stroke following endovenous laser ablation and extensive miniphlebectomy of varicose veins

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515610235 ◽

2015 ◽

Vol 31 (4) ◽

pp. 296-298 ◽

Cited By ~ 2

Author(s):

Luca Spinedi ◽

Daniel Staub ◽

Heiko Uthoff

Keyword(s):

Ischemic Stroke ◽

Laser Ablation ◽

Thermal Ablation ◽

Patent Foramen Ovale ◽

Great Saphenous Vein ◽

Varicose Veins ◽

Foramen Ovale ◽

Fatal Complication ◽

Endovenous Laser Ablation ◽

Endovenous Thermal Ablation

Stroke is a very rare but potential fatal complication of endovenous thermal treatment in patients with a right-to-left shunt. To our best knowledge, there are only two reports in the literature of stroke after endovenous thermal ablation of varicose veins, one after endovenous laser ablation and one after radiofrequency ablation and phlebectomy, both treated conservatively. This report describes a successful lysis in a patient with an ischemic stroke associated with bilateral endovenous heat-induced thrombosis class I after endovenous laser ablation of both great saphenous vein and extensive miniphlebectomy in a patient with an unknown patent foramen ovale.

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