THE EFFECTIVENESS OF 120-140 J/CM ENERGY DENSITY FOR THE ENDOVENOUS LASER ABLATION IN PATIENTS WITH DIABETES MELLITUS

Abstract

The aim of this study is to analyze the impact of the 120-140 J/cm energy for EVLA in patients with diabetes. Material and methods. The outcomes of 40 patients with varicose disease and diabetes mellitus as a comorbid condition were analyzed. Forty patients with varicose disease and diabetes mellitus were enrolled in the investigation. There were 27 women (67.5%) and 13 men (32.5%). The average age of the patients was 59.5±1.18 years, ranging from 44 to 74 years. The blood glucose level was 184.5±11.6 mmol/l, and the concentration of glycohemoglobin was equal to 8.5±0.25%. The average duration of the diabetes history was 10.6±0.91 years. Biolitec ELVeS Radial 2 Ring Fiber diode device and laser with 1470 nm wavelength and 120 – 140 J/cm energy were used for EVLA. VCSS results and recurrence rates were subjected to analysis in 1 week, 1 month, 6 months, and 1 year following the treatment. Results. The outcomes of the EVLA with high power energy for the treatment of varicose disease in patients with diabetes were not enough highlighted. The total VCSS score was for the right lower extremity: 4.75±0.725 - 1 week after EVLA; 1.93±0.547 - 1 month later; 0.79±0.306 - 6 months after; 0.36±0.151 - 1 year after; respectively for the left lower limb 5.37±0.806 - 1 week; 2.6±0.643 - after 1 month; 1.06±0.351 - after 6 months; 0.62±0.034 - after 1 year. 1 week after EVLA, there was an intense decrease in the pain index in the right lower limb, and after 1 month, almost 90% of the patients had no pain at all. In the 6-month and 1-year follow-ups, the pain had completely disappeared, and only 1 person reported having episodic pain. This trend is also reflected in the left leg. The intensity of pain in the left leg decreased significantly after 1 week of EVLA. During all observations, the intensity of pain was statistically significantly less than in the previous examinations (p<0.05). In the short term after EVLA the rapid reduction of the intensity of pain and oedema, and the disappearance of chronic venous insufficiency symptoms ensured earlier rehabilitation of patients. The recurrence was observed in 1 case (2.5%). Conclusion. 120-140 J/cm of energy was approved as an optimal density for the EVLA in patients with varicose and diabetes mellitus.