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

Cavallini, Alvise; Marcer, Daniela; Ruffino, S

doi:10.1016/j.avsg.2013.06.033

Cited by 18 publications

(22 citation statements)

References 27 publications

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“…This observation is most probably due to prolonged exposure of our population to risk factors as standing or setting and lack of physical exercises. The mean BMI in this study was 26.11 which is similar to previous studies (17,18) . These characteristics were equally distributed among the three studied groups.…”

Section: Discussionsupporting

confidence: 91%

Bare Tip versus Radial Endovenous Laser Ablation for the Treatment of Primary Varicose Veins

Reffat

Yamani

Taha

et al. 2016

Suez Canal University Medical Journal

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Background: New modalities in the Endo Venous Laser Ablation (EVLA) include the new design of the laser catheter tip are claimed to distribute more effectively the laser beam to the targeted varicose vein (VV) wall and therefore to achieve better results and produce less complications. These favorable results support the previously suggested better outcome of the EVLA compared to the open procedure. Aim: This study was conducted to confirm this assumption. Patients and Methods: 81 patients scheduled for treatment of VV were included and were divided into 3 equal groups. EVLA was used with a bare tip fiber for the first group and compared to a second group treated with a radial fiber. Success rate and post-operative results of both groups were compared to each other, then the mean results of EVLA group as a whole was compared to a third control group treated by surgical stripping. Results: There was no statistical significant difference between both EVLA groups. One patient (3.7%), from the bare tip group, had incomplete ablation that necessitated surgical excision. Fewer complications, shorter hospital stay, early return to work and faster reduction in venous clinical severity score (VCSS) were noted among the EVLA compared to the open group. Conclusion: EVLA using bar tip or radial fibers are effective and safe in treating vv with similar results. Their results are as effective as the open procedure with shorter hospital stay, fewer complications and early return to work.

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Section: Discussionsupporting

confidence: 91%

Bare Tip versus Radial Endovenous Laser Ablation for the Treatment of Primary Varicose Veins

Reffat

Yamani

Taha

et al. 2016

Suez Canal University Medical Journal

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“…Ball-tip optical fibers have been used in laser medicine since the 1990s, first for laser angioplasty 1,2 and neurosurgery, 3 and more recently for endovenous laser therapy. [4][5][6][7] Laser angioplasty employs the ball tip design by allowing the quartz fiber to taper from a small core to a larger diameter, smooth, rounded ball tip, thus minimizing the probability of mechanical dissection or perforation of the blood vessel wall. Neurosurgical procedures utilize a carbon coated, "hot" ball-tip fiber to absorb light and convert it into heat, thus providing ablative temperatures at low power and increasing safety margins near delicate tissues.…”

Section: Ball-tip Fibers In Laser Medicinementioning

confidence: 99%

Miniature ball-tip optical fibers for use in thulium fiber laser ablation of kidney stones

et al. 2016

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Optical fibers, consisting of 240-μm-core trunk fibers with rounded, 450-μm-diameter ball tips, are currently used during Holmium:YAG laser lithotripsy to reduce mechanical damage to the inner lining of the ureteroscope working channel during fiber insertion and prolong ureteroscope lifetime. Similarly, this study tests a smaller, 100-μm-core fiber with 300-μm-diameter ball tip during thulium fiber laser (TFL) lithotripsy. TFL was operated at a wavelength of 1908 nm, with 35-mJ pulse energy, 500-μs pulse duration, and 300-Hz pulse rate. Calcium oxalate/phosphate stone samples were weighed, laser procedure times were measured, and ablation rates were calculated for ball tip fibers, with comparison to bare tip fibers. Photographs of ball tips were taken before and after each procedure to track ball tip degradation and determine number of procedures completed before need for replacement. A high speed camera also recorded the cavitation bubble dynamics during TFL lithotripsy. Additionally, saline irrigation rates and ureteroscope deflection were measured with and without the presence of TFL fiber. There was no statistical difference (P > 0.05) between stone ablation rates for single-use ball tip fiber (1.3 AE 0.4 mg∕s) (n ¼ 10), multiple-use ball tip fiber (1.3 AE 0.5 mg∕s) (n ¼ 44), and conventional single-use bare tip fibers (1.3 AE 0.2 mg∕s) (n ¼ 10). Ball tip durability varied widely, but fibers averaged greater than four stone procedures before failure, defined by rapid decline in stone ablation rates. Mechanical damage at the front surface of the ball tip was the limiting factor in fiber lifetime. The small fiber diameter did not significantly impact ureteroscope deflection or saline flow rates. The miniature ball tip fiber may provide a cost-effective design for safe fiber insertion through the ureteroscope working channel and into the ureter without risk of instrument damage or tissue perforation, and without compromising stone ablation efficiency during TFL lithotripsy.

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“…It is an effective method to treat insufficient saphenous veins with occlusion rates to reach about 95%. [42][43][44][45][46][47] Thanks to the rapid evolution of the optical fiber, EVLT has also proven to be a versatile method to address a disease in itself multiform as the CVD. There is now the right fiber for any situation.…”

Section: Variablesmentioning

confidence: 99%

“…48 The newly developed fibers, like the radial ones, emit the laser energy radially around the tip directly into the venous wall; the light emission area is superior to the flat fiber, and the glowing tip of the fiber is not in direct contact with the vein's wall and this permits a more homogeneous effect on the venous wall with less penetration which could lead to less pain and bruising. 47,48 Some authors supposed also that damage induced by the use of the so-called waterspecific laser wavelengths (WSLWs), like the diode 1470 nm, with these newly developed fibers creates a lower inflammatory response to that produced from flat fibers and hemoglobin-specific lasers, 48 but to date no histological confirmation is available. The recent introduction of the radial slim TM fiber represents a further evolution.…”

Section: Variablesmentioning

confidence: 99%

Endovenous laser treatment of groin and popliteal varicose veins recurrence

2017

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Objectives Recurrent varicose veins following surgery is a common, complex and costly problem in vascular surgery. Treatment for RVV is technically more difficult to perform and patient satisfaction is poorer than after primary interventions. Nevertheless, traditional vein surgery has largely been replaced by percutaneous office-based procedures, and the patients with recurrent varicose veins have not benefited from the same advantages. In this paper, we propose an endovascular laser treatment that allows reducing the invasiveness and complications in case of SFJ and SPJ reflux after ligation and stripping of the great and small saphenous vein. Methods 8 SFJ and 1 SPJ stumps were treated by endovascular laser treatment in out-patient clinic. Endovascular laser treatment was performed with a 1470 nm diode laser and a 400 µc radial slim™ fiber. Intraoperative ultrasoud was used to guide the fiber position and the delivery of tumescent anesthesia. The gravity of chronic venous disease was determined according to the CEAP classification and the severity of symptoms was scored according to the revised Venous Clinical Severity Score (VCSS). Results The average linear endovenous energy density was 237 J/cm. Patients return to daily activities after a mean of 1.9 days after. The VCSS improved drastically from a mean of 8 pre-interventional to 1 at day 30 and until one year. During the follow-up period (mean 8 months, range: 5-17 months), all the stumps except one were occluded. All patients were very satisfied or satisfied with the method. No severe complications occurred. Conclusions Office-based endovascular laser treatment of groin and popliteal recurrent varicose veins with 1470 nm diode laser and radial-slim fiber is a safe and highly effective option, with a high success rate in the early post-operative period.

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

Cited by 18 publications

References 27 publications

Bare Tip versus Radial Endovenous Laser Ablation for the Treatment of Primary Varicose Veins

Bare Tip versus Radial Endovenous Laser Ablation for the Treatment of Primary Varicose Veins

Miniature ball-tip optical fibers for use in thulium fiber laser ablation of kidney stones

Endovenous laser treatment of groin and popliteal varicose veins recurrence

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