A Comparative Study of the Efficacy of Endovenous Laser Treatment of the Incompetent Great Saphenous Under General Anesthesia with External Air Cooling with and Without Tumescent Anesthesia

Osma, Esteban Hernández; Mordon, Serge; Marqa, Mohamad Feras; Vokůrka, J; Trelles, Mario A.

doi:10.1111/dsu.12063

Cited by 8 publications

(2 citation statements)

References 20 publications

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“…The vein diameter after tumescence seems to be one of the most important factors for the success of the EVLA procedure. 12,13 Before the procedure, perisaphenous subcutaneous tumescent saline solution infiltration is usually performed. It is claimed that this solution of local anesthesia serves three purposes.…”

Section: Discussionmentioning

confidence: 99%

“…However, diffusion of tumescent fluid is rapidly observed and can potentially reduce the efficacy as a heat sink. 13 In order to solve this problem, Memetoglu et al 14 have proposed to inject the tumescent solution not only before the laser procedure but also continuously during endovenous laser treatment. Moreover, during tumescent anesthesia, significantly higher plasma concentrations of lidocaine are observed in the face and neck than in the hypogastrium, buttocks and thighs, axillae, breast, and trunk 0.5-4 h after its infusion.…”

Section: Discussionmentioning

confidence: 99%

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Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser

Dumantepe

Uyar²

2013

Phlebology

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To date, most published endovenous laser ablation series describe the use of room temperature tumescence fluid infiltration of the perivenous stroma for tumescent analgesia and protection against thermal injury to the nearby structures. We describe an alternative technique using cold tumescence fluid infiltration, which is equally effective as, but safer than, room temperature tumescence fluid infiltration, and which yields better visual analog scores.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser

Dumantepe

Uyar²

2013

Phlebology

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Numerical simulation of endovenous laser treatment of the incompetent great saphenous vein with external air cooling

et al. 2012

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Endovenous laser treatment (ELT) has been proposed as an alternative in the treatment of reflux of the great saphenous vein. Before the procedure, peri-saphenous subcutaneous tumescent saline solution infiltration is usually performed. However, diffusion of this tumescent fluid is rapidly observed and can potentially reduce the efficacy as a heat sink. External skin cooling with cold air was proposed as an alternative solution. The objective of this study is to compare endovenous laser treatment without and with air cooling by realistic numerical simulations. An optical-thermal damage model was formulated and implemented using finite element modeling. The general model simulated light distribution using the diffusion approximation of the transport theory, temperature rise using the bioheat equation, and laser-induced injury using the Arrhenius damage model. Parameters, used in clinical procedures, were considered: power, 15 W; pulse duration, 1 s; fiber pull back, 3-mm increments every second; cold air applied in continuous mode during ELT; and no tumescent anesthesia. Simulations were performed for vein locations at 5, 10, and 15 mm in depth, with and without air cooling. For a vein located at 15 mm in depth, no significant difference was observed with and without cooling. For a vein located at 10 mm in depth, surface temperature increase up to 45 °C is observed without cooling. For a vein located at 5 mm, without cooling, temperature increase leads to irreversible damage of dermis and epidermis. Conversely, with air cooling, surface temperature reaches a maximum of 38 °C in accordance with recordings performed on patients. ELT of the incompetent great saphenous vein with external air cooling system is a promising therapy technique. Use of cold air on the skin continuously flowing in the area of laser shot decreased significantly the heat extent and the thermal damage in the perivenous tissues and the skin.

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Endovenöse Ablation der Stammvenenvarikose

Schuller‐Petrovič¹

2016

Wien Med Wochenschr

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In the past 15 years, the minimally invasive endovenous treatments of varicose veins have been widely accepted. The efficacy of the different endovenous methods and the minimal post operative side effects are meanwhile well documented in a large number of evidence based publications. The recent NICE Guidelines (2013) considering the varicose vein treatment recommend in case of an insufficiency of saphenous veins first the endovenous thermal ablation with radiofrequency or laser, then the ultrasound guided sclerotherapy and as the third line the classic surgical treatment with stripping and high ligation.

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A Comparative Study of the Efficacy of Endovenous Laser Treatment of the Incompetent Great Saphenous Under General Anesthesia with External Air Cooling with and Without Tumescent Anesthesia

Abstract: ELT surgery for the great saphenous vein can be safely performed using the air cooling method and is as efficacious as ELT done with tumescent anesthesia but takes significantly less time to perform.

Cited by 8 publications

References 20 publications

Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser

Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser

Numerical simulation of endovenous laser treatment of the incompetent great saphenous vein with external air cooling

Endovenöse Ablation der Stammvenenvarikose

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