Safety, feasibility, and early efficacy of the water-specific 1940-nm laser wavelength for ablation of saphenous incompetence
Objective: The aim of the present study was to evaluate the safety, feasibility, and early efficacy of saphenous vein ablation using a water-specific 1940-nm diode laser wavelength using low linear endovenous energy density. Methods: We retrospectively analyzed a series of patients who had undergone...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Journal of Vascular Surgery Cases and Innovative Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468428723000345 |
| _version_ | 1797797147841658880 |
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| author | H. Hong Keo, MD, MS Cassandra Somma, RN Christian Regli, MD Daniel Staub, MD Nicolas Diehm, MD, MBA Juliane Lindenberg, MD Roman Gaehwiler, MD Heiko Uthoff, MD |
| author_facet | H. Hong Keo, MD, MS Cassandra Somma, RN Christian Regli, MD Daniel Staub, MD Nicolas Diehm, MD, MBA Juliane Lindenberg, MD Roman Gaehwiler, MD Heiko Uthoff, MD |
| author_sort | H. Hong Keo, MD, MS |
| collection | DOAJ |
| description | Objective: The aim of the present study was to evaluate the safety, feasibility, and early efficacy of saphenous vein ablation using a water-specific 1940-nm diode laser wavelength using low linear endovenous energy density. Methods: We retrospectively analyzed a series of patients who had undergone endovenous laser ablation (EVLA) between July 2020 and October 2021 from the multicenter, prospectively maintained VEINOVA (vein occlusion with various techniques) registry. EVLA was performed using a water-specific 1940-nm radial laser fiber. In the same session, all insufficient tributaries were treated by phlebectomy or sclerotherapy. Tumescent anesthesia was injected into the perivenous space. The vein diameter, energy delivered, and linear endovenous density were reviewed at baseline. The incidence of venous thromboembolism, endovenous heat-induced thrombosis (EHIT), burns, phlebitis, paresthesia, and occlusion were reviewed at 2 days and 6 weeks of follow-up. We used descriptive statistics to describe the results. Results: Overall, 229 patients were identified. Of the 229 patients, 34 were excluded because of treatment of recurrent varicose veins at a previously operated site (residual or neovascularization). Finally, 108 patients with varicose veins and 87 with recurrent varicose veins (new varicose veins in an untreated area) due to disease progression were included in the present analysis. A total of 256 native saphenous veins (163 great saphenous veins, 53 small saphenous veins, and 40 accessory saphenous veins) in 224 legs had undergone EVLA. The mean patient age was 58.3 ± 16.5 years. Of the 195 patients, 134 (68.7%) were women and 61 (31.3%) were men. Nearly one half of the patients had a history of saphenous vein surgery (44.6%). The CEAP (clinical, etiology, anatomy, pathophysiology) class was C2 in 31 legs (13.8%), C3 in 108 (48.2%), C4a to C4c in 72 (32.1%), and C5 or C6 in 13 legs (5.8%). The treatment length was 34.8 ± 18.3 cm. The mean diameter was 5.0 ± 1.2 mm. The average linear endovenous density was 34.8 ± 9.2 J/cm. Concomitant miniphlebectomy was performed in 163 patients (83.6%) and concomitant sclerotherapy in 35 patients (18%). At 2 days and 6 weeks of follow-up, the occlusion rate of the treated truncal veins was 99.6% and 99.6%, respectively, with only one truncal vein (0.4%) with partial recanalization at 2 days and 6 weeks of follow-up. No cases of proximal deep vein thrombosis, pulmonary embolism, or EHIT had occurred at follow-up. Only one patient (0.5%) had developed calf deep vein thrombosis at 6 weeks of follow-up. The incidence of postoperative ecchymosis was rare (1.5%) and had resolved at 6 weeks of follow-up. Conclusions: EVLA of incompetent saphenous veins using the water-specific 1940-nm diode laser wavelength is feasible and appears to be safe and efficient with a high occlusion rate, minimal side effects, and a zero rate of EHIT. |
| first_indexed | 2024-03-13T03:44:48Z |
| format | Article |
| id | doaj.art-9da938b50ae24a619ed382b6baaa2f51 |
| institution | Directory Open Access Journal |
| issn | 2468-4287 |
| language | English |
| last_indexed | 2024-03-13T03:44:48Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Vascular Surgery Cases and Innovative Techniques |
| spelling | doaj.art-9da938b50ae24a619ed382b6baaa2f512023-06-23T04:43:36ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872023-06-0192101125Safety, feasibility, and early efficacy of the water-specific 1940-nm laser wavelength for ablation of saphenous incompetenceH. Hong Keo, MD, MS0Cassandra Somma, RN1Christian Regli, MD2Daniel Staub, MD3Nicolas Diehm, MD, MBA4Juliane Lindenberg, MD5Roman Gaehwiler, MD6Heiko Uthoff, MD7Vascular Institute Central Switzerland, Aarau, Switzerland; Department of Angiology, University Hospital and University of Basel, Basel, Switzerland; Correspondence: H. Hong Keo, MD, MS, Vascular Institute Central Switzerland, Aarenaustrasse 2b, Aarau 5000, SwitzerlandVascular Institute Central Switzerland, Aarau, SwitzerlandVascular Institute Central Switzerland, Aarau, SwitzerlandDepartment of Angiology, University Hospital and University of Basel, Basel, SwitzerlandVascular Institute Central Switzerland, Aarau, SwitzerlandVascular Institute Central Switzerland, Aarau, SwitzerlandVascular Institute Central Switzerland, Aarau, SwitzerlandDepartment of Angiology, University Hospital and University of Basel, Basel, Switzerland; Gefässpraxis am See – Lakeside Vascular Center, Lucerne, SwitzerlandObjective: The aim of the present study was to evaluate the safety, feasibility, and early efficacy of saphenous vein ablation using a water-specific 1940-nm diode laser wavelength using low linear endovenous energy density. Methods: We retrospectively analyzed a series of patients who had undergone endovenous laser ablation (EVLA) between July 2020 and October 2021 from the multicenter, prospectively maintained VEINOVA (vein occlusion with various techniques) registry. EVLA was performed using a water-specific 1940-nm radial laser fiber. In the same session, all insufficient tributaries were treated by phlebectomy or sclerotherapy. Tumescent anesthesia was injected into the perivenous space. The vein diameter, energy delivered, and linear endovenous density were reviewed at baseline. The incidence of venous thromboembolism, endovenous heat-induced thrombosis (EHIT), burns, phlebitis, paresthesia, and occlusion were reviewed at 2 days and 6 weeks of follow-up. We used descriptive statistics to describe the results. Results: Overall, 229 patients were identified. Of the 229 patients, 34 were excluded because of treatment of recurrent varicose veins at a previously operated site (residual or neovascularization). Finally, 108 patients with varicose veins and 87 with recurrent varicose veins (new varicose veins in an untreated area) due to disease progression were included in the present analysis. A total of 256 native saphenous veins (163 great saphenous veins, 53 small saphenous veins, and 40 accessory saphenous veins) in 224 legs had undergone EVLA. The mean patient age was 58.3 ± 16.5 years. Of the 195 patients, 134 (68.7%) were women and 61 (31.3%) were men. Nearly one half of the patients had a history of saphenous vein surgery (44.6%). The CEAP (clinical, etiology, anatomy, pathophysiology) class was C2 in 31 legs (13.8%), C3 in 108 (48.2%), C4a to C4c in 72 (32.1%), and C5 or C6 in 13 legs (5.8%). The treatment length was 34.8 ± 18.3 cm. The mean diameter was 5.0 ± 1.2 mm. The average linear endovenous density was 34.8 ± 9.2 J/cm. Concomitant miniphlebectomy was performed in 163 patients (83.6%) and concomitant sclerotherapy in 35 patients (18%). At 2 days and 6 weeks of follow-up, the occlusion rate of the treated truncal veins was 99.6% and 99.6%, respectively, with only one truncal vein (0.4%) with partial recanalization at 2 days and 6 weeks of follow-up. No cases of proximal deep vein thrombosis, pulmonary embolism, or EHIT had occurred at follow-up. Only one patient (0.5%) had developed calf deep vein thrombosis at 6 weeks of follow-up. The incidence of postoperative ecchymosis was rare (1.5%) and had resolved at 6 weeks of follow-up. Conclusions: EVLA of incompetent saphenous veins using the water-specific 1940-nm diode laser wavelength is feasible and appears to be safe and efficient with a high occlusion rate, minimal side effects, and a zero rate of EHIT.http://www.sciencedirect.com/science/article/pii/S24684287230003451940-nm Diode laserDVTEHITOcclusionPainSaphenous vein |
| spellingShingle | H. Hong Keo, MD, MS Cassandra Somma, RN Christian Regli, MD Daniel Staub, MD Nicolas Diehm, MD, MBA Juliane Lindenberg, MD Roman Gaehwiler, MD Heiko Uthoff, MD Safety, feasibility, and early efficacy of the water-specific 1940-nm laser wavelength for ablation of saphenous incompetence Journal of Vascular Surgery Cases and Innovative Techniques 1940-nm Diode laser DVT EHIT Occlusion Pain Saphenous vein |
| title | Safety, feasibility, and early efficacy of the water-specific 1940-nm laser wavelength for ablation of saphenous incompetence |
| title_full | Safety, feasibility, and early efficacy of the water-specific 1940-nm laser wavelength for ablation of saphenous incompetence |
| title_fullStr | Safety, feasibility, and early efficacy of the water-specific 1940-nm laser wavelength for ablation of saphenous incompetence |
| title_full_unstemmed | Safety, feasibility, and early efficacy of the water-specific 1940-nm laser wavelength for ablation of saphenous incompetence |
| title_short | Safety, feasibility, and early efficacy of the water-specific 1940-nm laser wavelength for ablation of saphenous incompetence |
| title_sort | safety feasibility and early efficacy of the water specific 1940 nm laser wavelength for ablation of saphenous incompetence |
| topic | 1940-nm Diode laser DVT EHIT Occlusion Pain Saphenous vein |
| url | http://www.sciencedirect.com/science/article/pii/S2468428723000345 |
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