alexa Lower energy endovenous laser ablation of the great saphenous vein with 980 nm diode laser in continuous mode.


Anatomy & Physiology: Current Research

Author(s): Kim HS, Nwankwo IJ, Hong K, McElgunn PS

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Abstract PURPOSE: To assess clinical outcomes, complication rates, and unit energy applied using 980 nm diode endovenous laser treatment at 11 watts for symptomatic great saphenous vein (GSV) incompetence and reflux disease. METHODS: Thirty-four consecutive ablation therapies with a 980 nm diode endovenous laser at 11 watts were studied. The diagnosis of GSV incompetence with reflux was made by clinical evaluation and duplex Doppler examinations. The treated GSVs had a mean diameter of 1.19 cm (range 0.5-2.2 cm). The patients were followed with clinical evaluation and color flow duplex studies up to 18.5 months (mean 12.19 months +/- 4.18). RESULTS: Using 980 nm diode endovenous laser ablation in continuous mode, 100\% technical success was noted. The mean length of GSVs treated was 33.82 cm (range 15-45 cm). The mean energy applied during the treatment was 1,155.81 joules (J) +/- 239.50 (range 545.40-1620 J) for a mean treatment duration of 90.77 sec +/- 21.77. The average laser fiber withdrawal speed was 0.35 cm/sec +/- 0.054. The mean energy applied per length of GSV was 35.16 J/cm +/- 8.43. Energy fluence, calculated separately for each patient, averaged 9.82 J/cm(2) +/- 4.97. At up to 18.5 months follow-up (mean 12.19 months), 0\% recanalization was noted; 92\% clinical improvement was achieved. There was no major complication. Minor complications included 1 patient with hematoma at the percutaneous venotomy site, 1 patient with thrombophlebitis on superficial tributary varices of the treated GSV, 24\% ecchymoses, and 32\% self-limiting hypersensitivity/tenderness/"pulling" sensation along the treatment area. One patient developed temporary paresthesia. Four endovenous laser ablation treatments (12\%) were followed by adjunctive sclerotherapies for improved cosmetic results. CONCLUSION: Endovenous laser ablation treatment of GSV using a 980 nm diode laser at 11 watts in continuous mode appears safe and effective. Mean energy applied per treated GSV length of 35.16 J/cm or mean laser fluence of 9.82 J/cm(2) appears adequate, resulting in 0\% recanalization and low minor complication rates. This article was published in Cardiovasc Intervent Radiol and referenced in Anatomy & Physiology: Current Research

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