Complications of Endovenous Lasers

Abstract

Endovenous laser ablation (EVLA) and radiofrequencey ablation have become the procedures of choice for the treatment of superficial venous insufficiency. Their minimally invasive technique and safety profile when compared with operative saphenectomy have led to this change. As EVLA has replaced saphenectomy as the procedure of choice, the distribution of complications has changed. We evaluated the most common and most devastating complications in the literature including burns, nerve injury, arterio-venous fistula (AVF), endothermal heat-induced thrombosis and deep venous thrombosis. The following review will discuss the most frequently encountered complications of treatment of superficial venous insufficiency using EVLA. The majority of the complications described can be avoided with the use of good surgical technique and appropriate duplex ultrasound guidance. Overall, EVLA has an excellent safety profile and should be considered among the first line for treatment of superficial venous reflux.

Postoperative Venous Thromboembolism in Patients Undergoing Endovenous Laser and Radiofrequency Ablation of the Saphenous Vein

“…2) Internationally, EHIT, especially C2 or higher, is observed in 0.2% to 7.7% of patients after EVA. 4,[14][15][16] According to our previous studies involving EVLA patients, the incidence of EHIT was 3.8% to 8.9%. [17][18][19] The results of this study showed that the incidence ranged from 2.7% to 6.6%.…”

The advent of non-thermal, non-tumescent techniques for treatment of varicose veins

“…34 The primary outcome measures included anatomic success, which was defined as occlusion of the treated vein and recanalised SSV or treatment failure defined as an segment of > 10 cm. The median pain score using a VAS was 2 cm (IQR 2-4 cm) and the median patient satisfaction was 8 (IQR [8][9]. No major complications were recorded, including no evidence of nerve injury and no DVT.…”

“…1,5-7 . However, because they make use of thermal energy to denature the venous wall, they have the potential of causing pain, skin burns, skin pigmentation, nerve damage and, even, arteriovenous fistula formation. 8,9 To minimise these possible complications, tumescent anaesthesia has to be infiltrated around the vein to be treated. This, in turn, can be a source of discomfort to patients.…”

Cryosclerosis. Az elfelejtett endovénás cryoablatio a vena saphena magna elégtelenségének kezelésében. Egy prospektív összehasonlító vizsgálat középtávú eredményei

“…Tekintve, hogy a cryosclerosishoz kapcsolt cros sectomia során nem szükséges a lágyéki feltárás során a beömlő vénákat átvágni, csak lekötni, ugyanis a VSM sem lesz exstirpálva, a neovascularisatio előfordulása nem válik vélhetően gyakoribbá, viszont a crossectomia elő nyei adottak [49]. Az endovénás hő indukálta thrombo sis (EHIT) [50], illetőleg az SFJneoreflux okozta reka nalizáció aránya jelentősen nőhet ellenben, ha nem kötjük le az SFJt.…”