Endovenous Laser Treatment of the Small Saphenous Vein with a 980-nm Diode Laser: Early Results

Abstract

Whereas numerous studies have been conducted regarding the outcome of the treatment of the great saphenous vein, few studies have been conducted on the small saphenous vein (SSV), especially concerning endovenous laser treatment. The objective was to evaluate the safety and efficacy of the 980-nm diode laser for the treatment of SSV reflux caused by saphenopopliteal junction (SPJ) incompetence. From October 2003 to April 2006, 390 SSVs in 344 subjects with varicose veins were treated with 980-nm diode laser energy delivered percutaneously into the SSV. Tumescent anesthesia (70-220 mL of 0.1% lidocaine) was delivered perivenously under ultrasound (US) guidance. The patients were evaluated clinically and with duplex US at 1 week, 1 month, 3 months, 6 months, 1 year, and thereafter to assess the efficacy of the treatment and the adverse reactions of the patients to it. Successful occlusion of the SSV, defined as the absence of flow on color Doppler imaging, was noted in 389 of the 390 SSVs (99.7%) after the initial treatment. The remaining 1 SSV was closed after the repeat treatment. Of 108 SSVs, 102 (94.4%) remained closed throughout the 12th-month follow-up. Bruising and tightness along the course of the treated vein was present in almost all the patients, but these disappeared in 1 to 2 weeks. Seven patients (2%) noted localized skin paresthesia, but there were no major complications like skin burns and deep vein thrombosis. Taking into account the high failure rates of incompetent SSV surgery and the anatomic complexity of SPJ, the endovenous 980-nm diode laser surgery is a safe and effective, cosmetically preferential procedure while a long-term follow-up is being awaited.