Endovenous Laser Ablation of the Great Saphenous Vein with a 1470 nm Wavelength Laser: Results of a Prospective, Single Centre Cohort Study

Abstract

Background : Endovenous laser ablation (EVLA) is a widely accepted treatment for venous insufficiency. Our aim was to report the standardised technique used in our centre and to evaluate the anatomic and clinical success rates. Methods : All details of patients treated with EVLA were prospectively collected in a database. A standardized examination and surgical protocol was used, and every detail in the technique was registered. A follow-up visit was organised after 1 week and after 4–6 weeks with a duplex.Results : A total of 441 limbs were treated in 366 patients using a 1470 nm wavelength laser with bare tip fiber (Biolitec®). At 6 weeks postoperative a total obliteration of the vein was established in 98,62% of the cases with 78,67% of the patients free from complaints. No major complications were reported. Minor complaints were low (10,74% induration, 3,9% paresthesia). 93,11% reported no pain, 5,2% mentioned moderate pain. Mean duration of absence was equal or less than 1 week (65,28%). Satisfaction level was high (92,84%, level 10).Conclusion : EVLA of the GSV and the Anterior Accessory Vein (AAV) with a 1470 nm wavelength laser with bare tip fiber is a minimally invasive, safe and effective technique. We are convinced that every detail is important: tumescence technique, Trendelenburg position, no external compression, and the position of the vein in the fascial sheath. Further reduction of linear endovenous energy density (LEED) used for EVLA can improve the therapy. This is possible by using a new fiber tip design (radial optical fiber) and needs further investigation.