Endovenous Laser Application

Sroka, Ronald; Pongratz, Thomas; Siegrist, K.; Burgmeier, Christine; Barth, Hans-Dieter; Schmedt, C.‐G.

doi:10.12687/phleb2134-3-2013

Cited by 15 publications

(7 citation statements)

References 45 publications

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“…Recently, systematic experimental investigations and analyses of clinical results have increased the knowledge of the relation between particular details of endovenous laser application and clinical results. 162,165,168,176 Due to the diversity of laser parameters (e.g., wavelength, light application system, power, irradiance, irradiation) and the corresponding variable interaction with the target tissue, physicians request for a precise, reproducible, safe, standardized procedure and treatment protocol, [177][178][179][180] which includes the strategic investigation of light application systems 168,176,181 as well as potential on-line feedback.…”

Section: Endovenous Laser Treatment Of Varicose Veinsmentioning

confidence: 99%

“…The approach was the development of a specific radial emitting fiber to deliver the energy in direction to the vessels wall. 167,168,176,190 In dependency of the used wavelength, the transmission through the existing thin blood layer around the fiber tip differs. As shown in Fig.…”

Section: Endovenous Light Applicationmentioning

confidence: 99%

“…In comparison to the bare fiber technique, the irradiance (if contact to the tissue is assumed) can be reduced by a factor of 7 to reach irradiance values just below the ablation threshold of tissue. 168,176 In tests of the radial fiber technique on an ex vivo vein model 167 using heparinised blood containing veins, a shrinkage in length, a thickening of the wall, and the increased rigidity assessed by digital inspection could be achieved perfectly without any perforation. 167,168,176,190 Additional investigation of the wavelength dependency of this treatment also showed that using a laser emitting at 980 nm an output power of P 980 ¼ ð20 AE 2Þ W is needed to achieve the desired macroscopic tissue alteration.…”

Section: Endovenous Light Applicationmentioning

confidence: 99%

“…168,176 In tests of the radial fiber technique on an ex vivo vein model 167 using heparinised blood containing veins, a shrinkage in length, a thickening of the wall, and the increased rigidity assessed by digital inspection could be achieved perfectly without any perforation. 167,168,176,190 Additional investigation of the wavelength dependency of this treatment also showed that using a laser emitting at 980 nm an output power of P 980 ¼ ð20 AE 2Þ W is needed to achieve the desired macroscopic tissue alteration. In contrast, for a 1470 nm emitting diode laser, an output power of P 1470 ¼ 6 to 8 W is only necessary to achieve the same macroscopic results.…”

Section: Endovenous Light Applicationmentioning

confidence: 99%

“…Investigations were performed to develop systems for endoluminal in vivo on-line monitoring of such parameter, during laser energy application and within the irradiation field. 176,211 MC simulation of optical detection of the shrinkage effect looks promising only for small vessel calibres. Using the radially emitted light of wavelengths between 600 nm (pilot beam) and 1500 nm (therapeutic wavelength), which is reflected by the vessels wall and then detected by the same fiber, showed that the moving vessel wall can only be detected when the distance between the fiber and tissue is <2 mm in case of being filled with pure water and <1 mm in case of the presence of blood.…”

Section: On-line Monitoring During Eltmentioning

confidence: 99%

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Medical laser application: translation into the clinics

Sroka¹,

Stepp²,

Hennig³

et al. 2015

J. Biomed. Opt

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Medical laser applications based on widespread research and development is a very dynamic and increasingly popular field from an ecological as well as an economic point of view. Conferences and personal communication are necessary to identify specific requests and potential unmet needs in this multi- and interdisciplinary discipline. Precise gathering of all information on innovative, new, or renewed techniques is necessary to design medical devices for introduction into clinical applications and finally to become established for routine treatment or diagnosis. Five examples of successfully addressed clinical requests are described to show the long-term endurance in developing light-based innovative clinical concepts and devices. Starting from laboratory medicine, a noninvasive approach to detect signals related to iron deficiency is shown. Based upon photosensitization, fluorescence-guided resection had been discovered, opening the door for photodynamic approaches for the treatment of brain cancer. Thermal laser application in the nasal cavity obtained clinical acceptance by the introduction of new laser wavelengths in clinical consciousness. Varicose veins can be treated by innovative endoluminal treatment methods, thus reducing side effects and saving time. Techniques and developments are presented with potential for diagnosis and treatment to improve the clinical situation for the benefit of the patient.

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Section: Endovenous Laser Treatment Of Varicose Veinsmentioning

confidence: 99%

Section: Endovenous Light Applicationmentioning

confidence: 99%

Section: Endovenous Light Applicationmentioning

confidence: 99%

Section: Endovenous Light Applicationmentioning

confidence: 99%

Section: On-line Monitoring During Eltmentioning

confidence: 99%

See 3 more Smart Citations

Medical laser application: translation into the clinics

Sroka¹,

Stepp²,

Hennig³

et al. 2015

J. Biomed. Opt

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Endoluminal application of glass-capped diffuser for ex vivo endovenous photocoagulation

et al. 2016

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Endovenous laser ablation (EVLA) has frequently been used to treat varicose veins for 20 years. In spite of 90˜95% occlusion rates, clinical complications such as burn and ecchymosis still occur due to excessive thermal injury to perivenous tissue. In the current study, a glass-capped diffusing applicator is designed to validate the feasibility of EVLA as an effective therapeutic device by applying circumferential light distribution. The proposed device is evaluated with a flat fiber as a reference in terms of temperature elevation, fiber degradation, and degree of coagulative necrosis after 532 nm-assisted EVLA at 100 J/cm. The diffusing fiber generates a 40% lower maximum temperature with a 90% lower transient temperature change in blood, compared to the flat fiber. Due to low irradiance (13.5 kW/cm ) and wide light distribution, the diffuser tip experiences no significant thermal degradation while severe carbonization occurs at the flat fiber tip. Ex vivo tissue tests verify that the diffusing fiber induces circumferential and consistent tissue denaturation to the vein wall (107.8 ± 7.8 µm) along with 19% vessel shrinkage. The proposed glass-capped diffusing applicator can be a feasible therapeutic device for EVLA with minimal complications by entailing low maximum temperatures and uniform tissue denaturation in the venous tissue.

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Homogeneously Emitting, Mechanically Stable, and Efficient fs‐Laser‐Machined Fiber Diffusers for Medical Applications

et al. 2020

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Background and Objectives: Light delivery is an essential part of therapy forms like photodynamic therapy (PDT), laser-induced thermotherapy, and endovenous laser therapy. While there are approaches to the light application for all three therapies, there is no diffuser that can be used for all three approaches. This diffuser must meet the following criteria: Homogeneous radiation profile over a length of 40 mm, efficient light extraction in the diffuser area, mechanical breakage resistance as well as thermal stability when applying high power. Study Design/Materials and Methods: An ultrashort pulse laser was used to inscribe inhomogeneities into the core of a fused-silica fiber core while scanning the laser focus within a linear arrangement of cuboids centered around the fiber axis. The manufactured diffuser was optically and mechanically characterized and examined to determine the maximum power that can be applied in a tissue environment. Results: Based on the analysis of all examined diffusers, the manufactured diffuser exhibits an emission efficiency ε = (81.5 ± 5.9)%, an intensity variability of (19 ± 5)% between distal and proximal diffuser end, and a minimum bending radius R b = (15.4 ± 1.5) mm. It was taken advantage of the fact that the outer areas of the fiber core do not undergo any structural changes due to the machining and therefore do not suffer a major loss of stability. Tissue experiments revealed that a maximal power of 15 W was deliverable from the diffuser without harming the diffuser itself. Conclusions: It could be shown that a diffuser manufactured by ultrafast-laser processing can be used for low power applications as well as for high power applications. Further tests have to show whether the mechanical stability is still maintained after the application of high power in a tissue environment. Lasers Surg. Med.

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Endovenous Laser Application

Cited by 15 publications

References 45 publications

Medical laser application: translation into the clinics

Medical laser application: translation into the clinics

Endoluminal application of glass-capped diffuser for ex vivo endovenous photocoagulation

Homogeneously Emitting, Mechanically Stable, and Efficient fs‐Laser‐Machined Fiber Diffusers for Medical Applications

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