Intravascular 1320-nm Laser Closure of the Great Saphenous Vein: A 6- to 12-Month Follow-up Study

Goldman, Mitchel P.; Mauricio, Maritess; Rao, Jaggi

doi:10.1111/j.1524-4725.2004.30431.x

Cited by 128 publications

(100 citation statements)

References 36 publications

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“…Indeed, the obliteration rate was found to be 100% over the entire follow-up period (2.5 years) (Table III), which was clearly better than observed in the previous studies performed without ligation. [11][12][13][14][15][16][17][18] Consistent with this finding, skin lesions and subjective symptoms were remarkably improved after treatment (Figure 1). Furthermore, no major complications, including DVT, were noted.…”

Section: Discussionsupporting

confidence: 73%

Safety and Effectiveness of Endovenous Laser Ablation Combined With Ligation for Severe Saphenous Varicose Veins in Japanese Patients

Izumi¹,

Ikeda

Yamashita

et al. 2016

Int. Heart J.

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SummaryEndovenous laser ablation (EVLA), which is a relatively new therapeutic option for saphenous varicose veins of the legs, is less invasive than conventional stripping surgery with ligation. In this study, we evaluated the safety and effectiveness of EVLA combined with ligation for severe saphenous varicose veins that were graded as ≥ C 4 by the CEAP classification. We treated 119 Japanese patients (141 limbs) between July 2005 and December 2007 utilizing a 1320-nm Nd:YAG laser. The obliteration rate of the treated veins was found to be 100% over the entire follow-up period (2.5 years). Consistent with this finding, all of the patients exhibited improved skin lesions (ie, skin pigmentation and ulceration). No major complications, including deep vein thrombosis (DVT) and nerve injury, were observed. A questionnaire survey with a reasonable response rate (66.4%) demonstrated that subjective symptoms and minor complications that were initially observed after EVLA, such as mild pain, numbness, indurations, and localized hot flashes, were remarkably improved by the end of the follow-up period. Furthermore, high levels of patient satisfaction were noted. Thus, EVLA combined with ligation constituted a safe and effective strategy for treating severe saphenous varicose veins in Japanese patients. (Int Heart J 2016; 57: 87-90) Key words: 1320-nm Nd:YAG laser, Skin lesions, High patient satisfaction S uperficial venous insufficiency is a common medical condition that increases with age. Although stripping surgery with high ligation of the saphenofemoral junction (SFJ ligation) has been the standard treatment for great saphenous varicose veins with reflux, several effective alternatives are currently available.Endovenous laser ablation (EVLA) is a minimally invasive technique that has become a common alternative in Japan. EVLA can be performed either with or without SFJ ligation, and controversy persists regarding whether performing SFJ ligation prior to EVLA is truly beneficial for decreasing the recurrence rate of varicose veins. Recent studies have demonstrated that EVLA with SFJ ligation results in less incompetent groin tributaries and less common recanalization after the procedure.1) Interestingly, however, the overall recurrence rate was not improved by performing SFJ ligation.1) This finding was inconsistent with a previous finding that the presence of incompetent groin tributaries contributed to the pathogenesis of recurrent varicosities.2) Neovascularization in the groin is one of the operative stress responses to the SFJ ligation procedure, and it acts as another principal cause of recurrence.3-7) Thus, the inconsistency noted above might be explained by the hypothesis that performing SFJ ligation not only leads to less incompetent groin tributaries but also augments neovascularization in the groin.EVLA is a relatively new technique, and it tends to be applied for mild varicose veins that have been evaluated as class C 2 or C 3 according to the CEAP classification. Therefore, although EVLA has been perfo...

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Section: Discussionsupporting

confidence: 73%

Safety and Effectiveness of Endovenous Laser Ablation Combined With Ligation for Severe Saphenous Varicose Veins in Japanese Patients

Izumi¹,

Ikeda

Yamashita

et al. 2016

Int. Heart J.

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“…Many different wavelengths and different types of optical fibers have been tested in attempts to achieve this objective. [1][2][3][4][5][6][7][8] Several authors have demonstrated that all of the wavelengths employed to treat varicose veins are equally capable of producing the desired anatomic results. The fundamental differences between different wavelengths are related to occurrence of adverse events.…”

Section: Introductionmentioning

confidence: 99%

Resultados de médio e longo prazo do tratamento endovenoso de varizes com laser de diodo em 1940 nm: análise crítica e considerações técnicas

Viarengo¹,

Viarengo²,

Martins³

et al. 2017

J. vasc. bras.

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Resumo Contexto Desde a introdução do laser endovenoso para tratamento das varizes, há uma busca pelo comprimento de onda ideal, capaz de produzir o maior dano seletivo possível com maior segurança e menor incidência de efeitos adversos. Objetivos Avaliar os resultados de médio e longo prazo do laser de diodo de 1940 nm no tratamento de varizes, correlacionando os parâmetros utilizados com a durabilidade do desfecho anatômico. Métodos Revisão retrospectiva de pacientes diagnosticados com insuficiência venosa crônica em estágio clínico baseado em clínica, etiologia, anatomia e patofisiologia (CEAP) C2 a C6, submetidos ao tratamento termoablativo endovenoso de varizes tronculares, com laser com comprimento de onda em 1940 nm com fibra óptica de emissão radial, no período de abril de 2012 a julho de 2015. Uma revisão sistemática dos registros médicos eletrônicos foi realizada para obter dados demográficos e dados clínicos, incluindo dados de ultrassom dúplex, durante o período de seguimento pós-operatório. Resultados A média de idade dos pacientes foi de 53,3 anos; 37 eram mulheres (90,2%). O tempo médio de seguimento foi de 803 dias. O calibre médio das veias tratadas foi de 7,8 mm. A taxa de sucesso imediato foi de 100%, com densidade de energia endovenosa linear (linear endovenous energy density, LEED) média de 45,3 J/cm. A taxa de sucesso tardio foi de 95,1%, com duas recanalizações por volta de 12 meses pós-ablação. Não houve nenhuma recanalização nas veias tratadas com LEED superior a 30 J/cm. Conclusões O laser 1940 nm mostrou-se seguro e efetivo, em médio e longo prazo, para os parâmetros propostos, em segmentos venosos com até 10 mm de diâmetro.

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“…1 Since then, there has been increasing progress in laser technology, and numerous studies have been performed using different wavelengths and types of laser. [2][3][4][5][6][7] The Food and Drug Administration (FDA)-approved lasers today are 810, 940, 980 and 1470 nm diode lasers and 1319 and 1320 nm neodymium-doped yttrium aluminium garnet (Nd:YAG) lasers. In parallel to advances in laser technology, studies began being performed concerning thermal ablation of the saphenous vein using radiofrequency energy, and permission for the use of radiofrequency energy in endovenous ablation was granted by the FDA in 1999.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Endovenous Laser and Radiofrequency Ablation in Treating Varices in the Same Patient

et al. 2017

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Introduction: To compare endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in different legs in the same individual in patients with venous insufficiency. Methods: Sixty patients with bilateral saphenous vein insufficiency were included. EVLA or RFA was applied to one of the patient's legs and RFA or EVLA to the other leg. Results: EVLA and RFA complications were hyperemia at 20.7% and 31.0%, ecchymosis at 31.0% and 51.7% and edema at 27.6% and 65.5%, respectively. The rate of recanalization was 6.8% in the RFA group. No recanalization was observed in EVLA group. The level of patients satisfied with EVLA was 51.7%, compared to 31.0% for RFA, while 17.2% of patients were satisfied with both procedures. Times to return to daily activity were 0.9 days in the EVLA group and 1.3 days in the RFA group. Conclusion: EVLA procedure may be superior to RFA in certain respects.

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Intravascular 1320-nm Laser Closure of the Great Saphenous Vein: A 6- to 12-Month Follow-up Study

Abstract: At 6 months or greater follow-up, a 5-W, 1320-nm intravascular laser with 1 mm/s automatic pullback, delivered through a diffusion-tip fiber, is safe and effective in treating an incompetent great saphenous vein up to 1.2 cm in diameter.

Cited by 128 publications

References 36 publications

Safety and Effectiveness of Endovenous Laser Ablation Combined With Ligation for Severe Saphenous Varicose Veins in Japanese Patients

Safety and Effectiveness of Endovenous Laser Ablation Combined With Ligation for Severe Saphenous Varicose Veins in Japanese Patients

Resultados de médio e longo prazo do tratamento endovenoso de varizes com laser de diodo em 1940 nm: análise crítica e considerações técnicas

Comparison of Endovenous Laser and Radiofrequency Ablation in Treating Varices in the Same Patient

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