Histological difference between pulsed wave laser and continuous wave laser in endovenous laser ablation

Kansaku, Rei; Sakakibara, Naoki; Amano, Atsushi; Endo, Hisako; Shimabukuro, Takashi; Sueishi, Michiaki

doi:10.1177/0268355514538248

Cited by 8 publications

(8 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, there was less vessel contraction at these sites in the current study. An in vivo study using an 810-nm laser detected a 26 % vessel diameter reduction by contraction with multiple perforations [9,10]. A study with 810-, 940-, and 980-nm lasers showed that these wavelengths cause the production of steam bubbles in veins filled with blood.…”

Section: Discussionmentioning

confidence: 99%

Comparing 1470- and 980-nm diode lasers for endovenous ablation treatments

et al. 2015

View full text Add to dashboard Cite

The purpose of this study was to compare the effectiveness of 1470- and 980-nm lasers with regard to power output, complications, recanalization rates, and treatment response. We prospectively evaluated the effectiveness of endovenous laser ablation (EVLA) in a total of 152 great and small saphenous veins from 96 patients. Lasers were randomly used based on the availability of the units. Patients were clinically evaluated for Clinical Etiologic Anatomic Pathophysiologic (CEAP) stage and examined with Doppler ultrasound. Treatment response was determined anatomically by occlusion of the vein and clinically by the change in the venous clinical severity score (VCSS). Seventy-eight of the saphenous veins underwent EVLA with a 980-nm laser and 74 underwent EVLA with a 1470-nm laser. Treatment response was (68) 87.2 % in the 980-nm group and (74) 100 % in the 1470-nm group (p = 0.004). The median VCSS decreased from 4 to 2 in the 980-nm group (p < 0.001) and from 8 to 2 (p < 0.001) in the 1470-nm group. At 1-year follow-up, seven veins treated with 980 nm and two veins treated with 1470 nm were recanalized (p = 0.16); the average linear endovenous energy density (LEED) was 83.9 (r, 55-100) J/cm and 58.5 (r, 45-115) J/cm, respectively (p < 0.001). Postoperative minor complications occurred in 23 (29.4 %) limbs in the 980-nm group and in 19 (25.6 %) limbs of the 1470-nm group (p = 0.73). EVLA with the 1470-nm laser have less energy deposition for occlusion and better treatment response.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparing 1470- and 980-nm diode lasers for endovenous ablation treatments

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Pulsed wave (PW) lasers have reported fewer side effects and higher occlusion rates using lower energy settings than continuous wave (CW) lasers. 9,28–30 Using a LEED of 60 J/cm, Kansaku et al. reported no perforations or ulcers using a 1320 nm PW laser when compared with a 1470 nm CW laser.…”

Section: Resultsmentioning

confidence: 99%

“…It has been suggested that PW delivery results in shock waves, which prevent or dislodge clots, while others have speculated that CW delivery results in higher temperatures and more carbonisation. 29,30 The significance of this may warrant examination in future studies.…”

Section: Pulsed Vs Continuous-wave Lasersmentioning

confidence: 99%

“…Pulsed wave (PW) lasers have reported fewer side effects and higher occlusion rates using lower energy settings than continuous wave (CW) lasers. 9,[28][29][30] Using a LEED of 60 J/cm, Kansaku et al reported no perforations or ulcers using a 1320 nm PW laser when compared with a 1470 nm CW laser. 30 The authors proposed that PW delivery, using a sufficiently high energy but a sufficiently long thermal relaxation time, may help avoid excess energy delivery which might lead to vein wall perforation.…”

Section: Pulsed Vs Continuous-wave Lasersmentioning

confidence: 99%

See 1 more Smart Citation

Factors affecting optimal linear endovenous energy density for endovenous laser ablation in incompetent lower limb truncal veins – A review of the clinical evidence

2016

View full text Add to dashboard Cite

Objectives The objective is to identify the factors that affect the optimal linear endovenous energy density (LEED) to ablate incompetent truncal veins. Methods We performed a literature review of clinical studies, which reported truncal vein ablation rates and LEED. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram documents the search strategy. We analysed 13 clinical papers which fulfilled the criteria to be able to compare results of great saphenous vein occlusion as defined by venous duplex ultrasound, with the LEED used in the treatment. Results Evidence suggests that the optimal LEED for endovenous laser ablation of the great saphenous vein is >80 J/cm and <100 J/cm in terms of optimal closure rates with minimal side-effects and complications. Longer wavelengths targeting water might have a lower optimal LEED. A LEED <60 J/cm has reduced efficacy regardless of wavelength. The optimal LEED may vary with vein diameter and may be reduced by using specially shaped fibre tips. Laser delivery technique and type as well as the duration time of energy delivery appear to play a role in determining LEED. Conclusion The optimal LEED to ablate an incompetent great saphenous vein appears to be >80 J/cm and <95 J/cm based on current evidence for shorter wavelength lasers. There is evidence that longer wavelength lasers may be effective at LEEDs of <85 J/cm.

show abstract

“…We read this article in Phlebology with great interest. 1 This is a very important subject and concerns the use of endovenous laser ablation.…”

mentioning

confidence: 99%

Concerning the publication: “Histological difference between pulsed wave laser and continuous wave laser in endovenous laser ablation” by Kansaku R, Sakakibara N, Amano A, Endo H, Shimabukuro T, Sueishi M. Phlebology 2015; 30: 429–434

Vuylsteke¹,

Mordon

2015

Phlebology

View full text Add to dashboard Cite

Histological difference between pulsed wave laser and continuous wave laser in endovenous laser ablation

Abstract: While endovenous laser ablation using continuous wave results in perforation in many cases, pulsed wave does not lead to perforation.

Cited by 8 publications

References 21 publications

Comparing 1470- and 980-nm diode lasers for endovenous ablation treatments

Comparing 1470- and 980-nm diode lasers for endovenous ablation treatments

Factors affecting optimal linear endovenous energy density for endovenous laser ablation in incompetent lower limb truncal veins – A review of the clinical evidence

Concerning the publication: “Histological difference between pulsed wave laser and continuous wave laser in endovenous laser ablation” by Kansaku R, Sakakibara N, Amano A, Endo H, Shimabukuro T, Sueishi M. Phlebology 2015; 30: 429–434

Contact Info

Product

Resources

About