Thermal Damage of the Inner Vein Wall During Endovenous Laser Treatment: Key Role of Energy Absorption by Intravascular Blood

Proebstle, Thomas M.; Sandhofer, Matthias; Kargl, A.; Gül, Doendue; Rother, Werner; Knop, J.; Lehr, Hans‐Anton

doi:10.1046/j.1524-4725.2002.01309.x

Cited by 152 publications

(124 citation statements)

References 11 publications

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“…A prospective randomized study (13) that compared the use of 980 nm and 810 nm lasers for endovenous obliteration procedures and a study (14) that compared the use of 810, 940, and 980 nm diode lasers did not find any significant differences in their levels of effectiveness and complication rates. We used a 940 nm laser in our study because it was readily available at our hospital.…”

Section: Discussionmentioning

confidence: 89%

Endovenous ablation with 940 nm laser for the treatment of the great saphenous vein insufficiency: the short-mid term results

Memetoğlu

Kurtcan²,

Erbasan³

et al. 2011

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 89%

Endovenous ablation with 940 nm laser for the treatment of the great saphenous vein insufficiency: the short-mid term results

Memetoğlu

Kurtcan²,

Erbasan³

et al. 2011

Diagn Interv Radiol

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“…The mechanism of heat conduction explains why saline solution-filled vessels only showed injury at sites of direct laser light versus wall impact, whereas a homogeneously injured wall occurred in blood-filled vessels now caused by heat conduction from the very hot tip [18]. Our results in Fig.…”

Section: Discussionmentioning

confidence: 59%

Heat conduction from the exceedingly hot fiber tip contributes to the endovenous laser ablation of varicose veins

et al. 2009

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Lower-extremity venous insufficiency is a common condition, associated with considerable health care costs. Endovenous laser ablation is increasingly used as therapy, but its mechanism of action is insufficiently understood. Here, direct absorption of the laser light, collapsing steam bubbles and direct fiber-wall contact have all been mentioned as contributing mechanisms. Because fiber tips have reported temperatures of 800-1,300°C during endovenous laser ablation, we sought to assess whether heat conduction from the hot tip could cause irreversible thermal injury to the venous wall. We approximated the hot fiber tip as a sphere with diameter equal to the fiber diameter, having a steady state temperature of 800°C or 1,000°C. We computed venous wall temperatures due to heat conduction from this hot sphere, varying the pullback velocity of the fiber and the diameter of the vein. Venous wall temperatures corresponding to irreversible injury resulted for a 3 mm diameter vein and pullback velocities <3 mm/s but not for 5 mm and ≥1 mm/s. The highest wall temperature corresponded to the position on the wall closest to the fiber tip, hence it moves longitudinally in parallel with the moving fiber tip. We concluded that heat conduction from the hot fiber tip is a contributing mechanism in endovenous laser ablation.

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“…Only administration of a relatively high energy per unit of length results in sufficiently high temperatures to cause denaturing of collagen. 33 During endovenous laser ablation, intraluminal temperatures can rise to over 100ºC, 28,[34][35][36][37][38][39] and these temperature profiles are independent of wavelength, i.e. use of different wavelengths does not influence the endovenous temperature profile.…”

Section: Adverse Events N (%)mentioning

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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Thermal Damage of the Inner Vein Wall During Endovenous Laser Treatment: Key Role of Energy Absorption by Intravascular Blood

Abstract: Intravascular blood plays a key role for homogeneously distributed thermal damage of the inner vein wall during EVLT.

Cited by 152 publications

References 11 publications

Endovenous ablation with 940 nm laser for the treatment of the great saphenous vein insufficiency: the short-mid term results

Endovenous ablation with 940 nm laser for the treatment of the great saphenous vein insufficiency: the short-mid term results

Heat conduction from the exceedingly hot fiber tip contributes to the endovenous laser ablation of varicose veins

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

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