Endovenous Laser Ablation Of Saphenous Vein Research Articles

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Background Active venous leg ulcer (VLU) is the most severe manifestation of chronic venous disease which not only affects patients’ health, but also decreases the quality of life, and delivers economic burdens. Treatment of superficial venous reflux with early endovenous laser ablation (EVLA) has been associated with reducing ulcer recurrence levels and promoting faster VLU healing. We reported three cases of patients with active VLU undergoing EVLA with different approaches. Case illustration Three patients came with complaint of leg ulcer, diagnosed with C6sEpAsdPr, with venous clinical severity scores (VCSS) of 15, 23, and 22 respectively. Severe great saphenous veins (GSV) reflux was found in all patients by duplex ultrasound examination. The second patient had undergone above-the-knee EVLA. All patients underwent EVLA using 1470-nano meter wavelength laser device and ELVeS radial fiber (Biolitec, Bonn, Germany). The laser energy protocol used was 6 W linear endovenous energy density (LEED) 50 J/cm for proximal until media ATK GSV ablation, 5 W LEED 40 J/cm for media ATK until proximal below-the-knee (BTK) GSV, and 2 W LEED 20 J/cm for proximal until distal BTK GSV. The third patient was also treated with EVLA for small saphenous vein severe reflux. Follow-up until 6 months post-EVLA showed significant healing of the ulcer with 14, 16, and 17 VCSS reduction consecutively without any complication. Conclusion We’ve reported three cases of patients with active VLU undergoing EVLA until BTK with significant results. The EVLA of GSV until BTK where there is still significant reflux is safe and provides satisfactory results in patients with VLU.

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Background Active venous leg ulcer (VLU) is the most severe manifestation of chronic venous disease which not only affects patients’ health, but also decreases the quality of life, and delivers economic burdens. Treatment of superficial venous reflux with early endovenous laser ablation (EVLA) has been associated with reducing ulcer recurrence levels and promoting faster VLU healing. We reported three cases of patients with active VLU undergoing EVLA with different approaches. Case illustration Three patients came with complaint of leg ulcer, diagnosed with C6sEpAsdPr, with venous clinical severity scores (VCSS) of 15, 23, and 22 respectively. Severe great saphenous veins (GSV) reflux was found in all patients by duplex ultrasound examination. The second patient had undergone above-the-knee EVLA. All patients underwent EVLA using 1470-nano meter wavelength laser device and ELVeS radial fiber (Biolitec, Bonn, Germany). The laser energy protocol used was 6 W linear endovenous energy density (LEED) 50 J/cm for proximal until media ATK GSV ablation, 5 W LEED 40 J/cm for media ATK until proximal below-the-knee (BTK) GSV, and 2 W LEED 20 J/cm for proximal until distal BTK GSV. The third patient was also treated with EVLA for small saphenous vein severe reflux. Follow-up until 6 months post-EVLA showed significant healing of the ulcer with 14, 16, and 17 VCSS reduction consecutively without any complication. Conclusion We’ve reported three cases of patients with active VLU undergoing EVLA until BTK with significant results. The EVLA of GSV until BTK where there is still significant reflux is safe and provides satisfactory results in patients with VLU.

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Background: Active venous leg ulcer (VLU) is the most severe manifestation of chronic venous disease which not only affects patients’ health, but also decreases the quality of life, and delivers economic burdens. Treatment of superficial venous reflux with early endovenous laser ablation (EVLA) has been proven to reduce ulcer recurrence levels and promote faster VLU healing. We reported three cases of patients with active VLU undergoing EVLA with different approaches. Case illustration: Three patients came with complaint of leg ulcer, diagnosed with C6sEpAsdPr, with venous clinical severity scores (VCSS) of 15, 23, and 22 respectively. Severe great saphenous veins (GSV) reflux was found in all patients by duplex ultrasound examination. The second patient had undergone above-the-knee EVLA. All patients underwent EVLA using 1470-nano meter wavelength laser device and ELVeS radial fiber (Biolitec, Bonn, Germany). The laser energy protocol used was 6 W linear endovenous energy density (LEED) 50 J/cm for proximal until media ATK GSV ablation, 5 W LEED 40 J/cm for media ATK until proximal below-the-knee (BTK) GSV, and 2 W LEED 20 J/cm for proximal until distal BTK GSV. The third patient was also treated with EVLA for small saphenous vein severe reflux. Follow-up until 6 months post-EVLA showed significant healing of the ulcer with 14, 16, and 17 VCSS reduction consecutively without any complication. Conclusion: We’ve reported three cases of patients with active VLU undergoing EVLA until BTK with significant results. The EVLA of GSV until BTK is safe and provides satisfactory results in patients with VLU.

Randomized Controlled Trial of Great Saphenous Vein Endovenous Laser Ablation by 1940-nm Radial Fiber Using High and Low Energy in Symptomatic Patients with Varicose Veins and Saphenofemoral Junction Incompetence

Randomized Controlled Trial of Great Saphenous Vein Endovenous Laser Ablation by 1940-nm Radial Fiber Using High and Low Energy in Symptomatic Patients with Varicose Veins and Saphenofemoral Junction Incompetence

Comparative study between great saphenous vein endovenous laser ablation (EVLA) and modified haemodynamic correction (CHIVA) as a treatment for varicose veins

Varicose veins (VV) could be a handicapping condition which may lead to limb swelling, pain and venous stasis ulcer. Prevalence of VV could present from 1% to 73% and from 2% to 56% at women and men respectively. CHIVA has been developed through the last two decades and is currently the second most common surgical procedure for the operative management of VV. Endovenous laser treatment of GSV was approved by FDA in 2002 and SSV was approved in 2003. EVLT allows delivery of Laser energy directly into the blood vessel lumen. EVLT with a 1470-nm diode Laser system is clinically safe, feasible and well-tolerated technique without scar and allows people to return to their normal daily activities rapidly. In a prospective comparative study between January 2018 and January 2020, 40 patients from those attended the outpatient departments complaining from VV were assessed according to the CEAP classification and ultrasonic duplex and arranged into group I (CHIVA) and group II (EVLA). Both CHIVA operation and EVLA were performed under local anesthesia. Cases were reviewed regularly at the outpatient clinic for 6 months for recurrence and complications. The recurrence occurred at 2/20 and 0/20 at CHIVA and EVLA respectively.

Comparative study between great saphenous vein endovenous laser ablation and modified hemodynamic correction (conservative hemodynamic correction of venous insufficiency) as a treatment for varicose veins

Background Varicose veins could be a complicated condition, which may lead to limb swelling, pain, and venous ulcer. Conservative hemodynamic correction of venous insufficiency (CHIVA) has been developed through the past two decades and is currently the second most common surgical procedure for the operative treatment of varicose veins. Endovenous laser treatment of great saphenous vein was approved by FDA in 2002 and short saphenous vein (SSV) was approved in 2003. Endovenous laser ablation (EVLA) is a clinically safe, feasible, and well-tolerated technique without scar and allows people to return to their normal daily activities rapidly. Patients and methods In a prospective comparative study between January 2018 and January 2020, 40 patients complaining of varicose veins were assessed according to the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification and ultrasonic duplex and arranged into group I (CHIVA) and group II (EVLA). Both CHIVA operation and EVLA were performed under local anesthesia. Follow-up for 6 months was done. Results Recurrence occurred in 2/20 and 0/20 patients in CHIVA and EVLA groups, respectively. Regarding the aesthetic satisfaction of the patient, EVLA was better, with two unsatisfied patients in EVLA in contrast to five unsatisfied patients in CHIVA. The wound infection rate was 1/20 and 0/20 in CHIVA and EVLA, respectively. CHIVA is favored over EVLA considering the rest of the complications. Bruises, thrombosis, and nerve damage are found to be 5/20, 0/20, and 0/20, respectively, in CHIVA group when compared with the results of EVLA group, which were 9/20, 1/20, and 2/20, respectively. Conclusion CHIVA is safe, effective, and less invasive. EVLA is now considered as one of the top technologies to be used in the management of varicose veins with good functional outcome. EVLA can be done as an outpatient procedure. Each type of these interventions should be tailored according to each patient’s variables such as degree of reflux in great saphenous vein, presence of incompetent perforators, and aesthetic requirements of the patient.

Results of Great Saphenous Vein Endovenous Laser Ablation with a Wavelength of 1470 nm Using Radial 2ring Fiber With Different Linear Energy Density

Results of Great Saphenous Vein Endovenous Laser Ablation with a Wavelength of 1470 nm Using Radial 2ring Fiber With Different Linear Energy Density

Endovenous Ablation of Incompetent Saphenous Veins with a New 1,540-Nanometer Diode Laser and Ball-Tipped Fiber

Endovenous laser ablation (EVLA) is an efficient method to treat incompetent saphenous veins with high occlusion rates. The major side effects are postoperative pain and bruising. Laser systems with higher wavelengths, associated with new energy delivery devices, have recently shown excellent short-term results, while reducing the previously reported side effects. The aim of this study is to show the first outcome after EVLA of incompetent saphenous veins with a newly developed ball-tipped fiber and a new wavelength 1,540-nm diode laser. Forty-five incompetent saphenous veins in 35 patients (27 women) were treated: 33 great saphenous veins, 6 short saphenous veins, and 6 anterior saphenous veins. The gravity of chronic venous disease was determined according to the clinical-etiology-anatomy-pathophysiology (CEAP) classification, and the severity of symptoms was scored according to the revised Venous Clinical Severity Score. Patient satisfaction was assessed on a 0-3 scale. The average linear endovenous energy density was 63.5 J/cm of vein length. Patients returned to daily activities after a mean of 1.7 days (SD: 2) after treatment. The modified CEAP clinical severity score improved drastically from a preintervention mean of 4.9 (SD: 2.6) to 0.17 (SD: 0.38) at day 30. During the follow-up period (mean: 168 days [range: 90-240 days]), all the veins were occluded. All patients except 1 were satisfied or very satisfied with the method. No severe complications occurred. Two patients (5%) developed mild paresthesia in the treated area, which spontaneously resolved after 3 months. Postoperative ecchymoses are frequent (83%). Sixteen patients (43%) experienced pain, but only 5 patients (14%) described it as quite intense and required analgesic therapy. EVLA of saphenous veins with a 1,540-nm diode laser using a ball-tipped fiber is a safe and efficient therapy option, with a high success rate in the early postoperative period.

Arterio-Venous Fistula Following Endovenous Laser Ablation for Varicose Veins

Endovenous laser ablation (EVLA) obliterates incompetent truncal veins as an alternative to varicose veins surgery. We describe 3 patients who developed an arterio-venous fistula (AVF) following great (GSV: 1) or small (SSV: 2) saphenous vein EVLA. Two fistulae closed spontaneously with conservative management. Concomitant venous and arterial wall thermal injury or needle trauma during administration of tumescent anaesthesia may cause this rare complication. Haemodynamic effects appear minimal and spontaneous closure is likely, supporting a non-interventional policy.