Abstract
Abstract Background Water-specific 1470-nm lasers enable vein ablation at lower energy densities and with fewer side effects because they target interstitial water in the vessel wall. Objectives To determine great saphenous vein (GSV) occlusion rate after thermal ablation with 1470-nm laser using 7W power and to evaluate clinical outcomes and complications. Method Nineteen patients (31 GSVs) underwent thermal ablation. Follow-up duplex scanning, clinical evaluation using the Venous Clinical Severity Score (VCSS), and evaluation of procedure-related complications were performed at 3-5 days after the procedure and at 30 and 180 days. Results Mean patient age was 46 years and 17 of the patients were female (89.47%). Of 31 limbs treated, 2 limbs were clinical class C2, 19 were C3, 9 were C4, and 1 limb was C5 according to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. Mean linear endovenous energy density was 33.53 J/cm. The GSV occlusion rate was 93.5% immediately after treatment, 100% at 3-5 days and 100% at 30 days after treatment and 87.1% 180 days after treatment. There was a significant reduction in VCSS at all time points. Conclusions The data from this study support the possibility that the incidence of complications can be reduced without significantly affecting the clinical outcomes, by using lower energy density. However, this appears to be at the cost of reduced efficacy in terms of GSV occlusion rates.
Highlights
Chronic venous insufficiency (CVI) caused by varicose veins is a common medical condition and prevalence rates in adults can be as high as 28% to 35%
The technique of fiber insertion through the needle puncture was used in all 31 great saphenous vein (GSV) treated (100%)
The thermal ablation therapy investigated in this study, using a 1470-nm water-specific laser, allowed ablation at lower laser fluence, leading to a reduction in the energy required for successful treatment
Summary
Chronic venous insufficiency (CVI) caused by varicose veins is a common medical condition and prevalence rates in adults can be as high as 28% to 35%.1 The impact of CVI on patients’ quality of life is comparable to that of other common chronic diseases, such as arthritis, diabetes, and cardiovascular disease.[2]Conventional treatment of great saphenous vein (GSV) insufficiency includes high ligation at the saphenofemoral junction (SFJ) combined with stripping of the GSV. Chronic venous insufficiency (CVI) caused by varicose veins is a common medical condition and prevalence rates in adults can be as high as 28% to 35%.1. Objectives: To determine great saphenous vein (GSV) occlusion rate after thermal ablation with 1470-nm laser using 7W power and to evaluate clinical outcomes and complications. Conclusions: The data from this study support the possibility that the incidence of complications can be reduced without significantly affecting the clinical outcomes, by using lower energy density. This appears to be at the cost of reduced efficacy in terms of GSV occlusion rates.
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