Endovenous 1470 nm laser treatment of the saphenous vein: Early report of pain assessment

Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey - .
The Journal of cardiovascular surgery (Impact Factor: 1.46). 04/2013; 54(2):263-7.
Source: PubMed


The aim of the paper was to evaluate the rate of postoperative pain by using endovenous laser ablation with wave-length of 1470 nm for incompetent saphenous veins in our single center experience.

A non-randomized prospective trial was performed. Patients with symptomatic varicose small saphenous vein and great saphenous vein were considered suitable for endovenous laser ablation. The VenaCure EVLT™ (Angiodynamics, Queensbury, NY) generator was used to provide laser energy (1470 nm emission wavelength). Pain was assessed on the 7th days, 1st months, 3rd months, and 6th months using a visual analog scale rating of 0 cm (no pain) to 10 cm (worst imaginable pain).

Of the 30 patients who eventually underwent endovenous laser ablation, 14 underwent bilateral treatment. Totally, 44 treated legs were scored. When questioned by using a visual analog scale pain score of 0-10, patients, on average, graded their pain 3.86 ± 1.04 at admission, 2.83 ± 0.91 at 1 week, 1.46 ± 0.63 at 1 month, 0.63 ± 0.49 at 3 months, and 0.07 ± 0.25 at 6 months. No major complication occurred, and there was no deep venous thrombosis or pulmonary embolism nor skin ulceration.

Endovenous laser ablation for chronic venous insufficiency with a 1470-nm diode laser appears to be effective and safe. The procedure is simple to perform, well accepted by patients and relatively atraumatic.

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Available from: Irfan Celebi, Jan 30, 2015
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    ABSTRACT: Purpose: To demonstrate 1-year outcomes after low-energy endovenous laser ablation (EVLA) of incompetent saphenous veins with linear endovenous energy density (LEED) of 80 J/cm or lower with the use of a 1,470-nm diode laser. Materials and methods: Incompetent saphenous veins in 236 patients (355 limbs; Clinical/Etiology/Anatomy/Pathophysiology classifications of C2-C4) were treated by EVLA with a bare-tipped 1,470-nm laser with LEED no greater than 80 J/cm (mean, 72.4 J/cm) and laser power of 8-12 W. Patients were evaluated clinically and with duplex ultrasonography at 1 week and 1, 3, 6, and 12 months after EVLA to assess the technical and clinical success and complication rates. Results: In the 355 limbs, the technical success rate was 100%. The great saphenous vein (GSV) remained occluded in all 229 limbs (100%) after 1 week, 202 of 203 limbs (99.5%) after 1 month, 157 of 158 limbs after 3 months (99.3%), all 99 limbs after 6 months (100%), and all 41 limbs after 1 year (100%). The small saphenous vein (SSV) remained occluded in all 103 limbs (100%) after 1 week, all 94 limbs (100%) after 1 month, 68 of 69 limbs (98.5%) after 3 months, 40 of 41 limbs (97.5%) after 6 months, and all 14 limbs after 1 year (100%). Two GSVs and two SSVs were recanalized and underwent repeated EVLA. No major complications occurred, although bruising (21% of cases), pain (15%), and paresthesia (4%) were observed. Conclusions: Low-energy EVLA with the use of a 1,470-nm laser with LEED of 80 J/cm or lower is an effective, safe, and technically successful option for the treatment of incompetent saphenous veins.
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