Middle-Term Results of 980 nm and 1470 nm Laser and Endovenosus Laser Ablation Theraphy in Lower Extremity Surface Venous Insufficiency Treatment
Abstract
Objective: Superficial venous insufficiency of the lower extremities is a common disease that causes clinical symptoms and can extend to venous ulcers if left untreated. Surgery has been the primary treatment method for many years in the treatment of superficial venous insufficiency and varicose veins. Endovenous laser ablation (EVLA) is a safe and effective minimally invasive treatment method that has recently come to the fore in the treatment of saphenous vein insufficiency. In this study, we aimed to compare the effectiveness, complications, and early and mid-term results of EVLA treatments with different wavelength lasers.
Material and Methods: A hundred symptomatic superficial venous insufficiency patients who applied to Kahramanmaraş Sütçü İmam University Faculty of Medicine Cardiovascular Surgery outpatient clinic and had treatment indication and planned EVLA were included in the study. The patients were divided into two groups. 25 patients had bilateral disease, and a total of 125 lower extremities were treated. A 10W laser with a wavelength of 980 nm was applied to one group (Group 1), and a 10W laser with a wave length of 1470 nm (Group 2) was applied to the other group.
Results: In the 6th-month follow-up, complete occlusion continued in all of the 1470 nm laser-applied group, while recanalization was observed in 3 extremities (5%) of the 980 nm laser-applied patients. Venous clinical severity score (VCSS) and VAS scores were similar in both groups before the procedure. After the procedure, both VCSS (p=0,002) and VAS scores(p<0,001) were significantly lower in Group 2. Likewise, the time to return to daily activities (p<0,001) and the time to feel pain (p<0,001) were shorter in Group 2. While major complications were not seen in both groups, ecchymosis, paresthesia, induration, and analgesia requirement, which are considered minor complications, were less in Group 2 (p<0,0001, p<0,0001, p<0,0001, p<0,001 respectively).
Conclusion: In this study, it was determined that the high laser wavelength used in EVLA treatment was more effective and less postoperative side effects compared to lasers with low laser wavelengths.
Keywords
endovenous laser ablation , varicose ven , venous insuffiency
Kaynakça
- Eroğlu E, Yasım A. A Randomised Clinical Trial Comparing N-Butyl Cyanoacrylate, Radiofrequency Ablation and Endovenous Laser Ablation for the Treatment of Superficial Venous Incompetence: Two Year Follow up Results. European Journal of Vascular and Endovascular Surgery 2018;56(4):553-560. Doi: https://doi.org/10.1016/j.ejvs.2018.05.028
- Durai R, Srodon PD, Kyriakides C. Endovenous laser ablation for superficial venous insufficiency. Int J Clin Pract. 2010 Jan;64(1):61-6. doi: 10.1111/j.1742-1241.2008.01741.x.
- van den Bremer J, Joosten PP, Hamming JF, Moll FL. Implementation of endovenous laser ablation for varicose veins in a large community hospital: the first 400 procedures. Eur J Vasc Endovasc Surg. 2009 Apr;37(4):486-91. doi: 10.1016/j.ejvs.2008.11.029.
- Campbell WB, Decaluwe H, Macintyre JB, Thompson JF, Cowan AR. Most patients with varicose veins have fears or concerns about the future, in addition to their presenting symptoms. Eur J Vasc Endovasc Surg. 2006 Mar;31(3):332-4. doi: 10.1016/j.ejvs.2005.08.009.
- Min RJ, Khilnani N, Zimmet SE. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 2003 Aug;14(8):991-6. doi: 10.1097/01.rvi.0000082864.05622.e4.
- Yılmaz S. Alt Ekstremite Venöz Sistem Anatomisi ve Ultrasonografi İncelemesi. 27. Ulusal Radyoloji Kongresi Kurs Kitabı 2006; syf: 94-100.
- Scott TE, LaMorte WW, Gorin DR, Menzoian JO. Risk factors for chronic venous insufficiency: a dual case-control study. J Vasc Surg. 1995 Nov;22(5):622-8. doi: 10.1016/s0741-5214(95)70050-1.
- Teruya TH, Ballard JL. New approaches for the treatment of varicose veins. Surg Clin North Am. 2004 Oct;84(5):1397-417, viii-ix. doi: 10.1016/j.suc.2004.04.008.
- Almeida JI, Raines JK. Radiofrequency ablation and laser ablation in the treatment of varicose veins. Ann Vasc Surg. 2006 Jul;20(4):547-52. doi: 10.1007/s10016-006-9098-8.
- Desmyttère J, Grard C, Wassmer B, Mordon S. Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg. 2007 Dec;46(6):1242-7. doi: 10.1016/j.jvs.2007.08.028.