Trattamento endovascolare dell’insufficienza della vena grande safena mediante laser

Abstract

The aim of this study was the development of a new, even less invasive technique, for the treatment of varicose veins of the lower limbs than traditional surgery (ligation with stripping of the saphenous vein). The new interventional radiological procedure uses the 810- to 980-nm endovascular laser fibre proposed by Min et al. Our technique involves the superselective catheterisation of the great saphenous vein under fluoroscopy with contralateral venous access achieved by performing iliac crossover. Retrograde and anterograde phlebographies are performed with a needle cannula positioned in the dorsum of the foot. This enables accurate venous mapping during the procedure of laser photothermolysis. We treated 52 patients between June 2003 and June 2004, with a percentage of recanalisation of 7.5% at 1 year. The contralateral approach allows greater control over the entire procedure, with a reduction in potential risks in relation to the saphenofemoral junction given that, unlike in the technique proposed by Min et al. the tip of the laser is directed at all times towards the saphenous vein and never towards the femoral vein. This more radical procedure offers a significant reduction in the possibility of relapse of varicose disease of the saphenofemoral junction.