Endovenous laser ablation procedure of great saphenous vein with a 1470-nm diode laser is a minimally invasive, safe, and efficient treatment option in all-suitable patients with high short- and mid-term success rate.

Different systems for delivering tumescent solution exist in endovenous laser ablation (EVLA). This study evaluated three different tumescent delivery systems in patients with primary varicose veins due to great saphenous vein reflux who were treated with EVLA. In this prospective non-randomized study, 60 patients with isolated GSV varicose veins were divided into three groups. All patients received EVLA treatment. Three different tumescent solution delivery systems were used. Systems consisted of a needle and a syringe in Group 1, a needle connected to an infusion bag system in Group 2 and a peristaltic infiltration pump in Group 3. Tumescent delivery durations were in Group 1: 6.56 SD 1.18 minutes, Group 2: 6.05 SD 2.19 minutes and Group 3: 5.19 SD 1.15 minutes (P = 0.014). In the outcomes of the study there were no significant difference between groups. Although peristaltic pump systems might provide shorter tumescent delivery durations without hand fatigue, shorter duration does not have any practical importance (about 1 minute and also it is not cost-effective. For delivering tumescent solutions in EVLA procedures, there was no major superiority between systems.

We believe that delivering the tumescent solution in a distal to proximal direction increases the comfort of both patient and surgeon with lower tumescent volume during the EVLA of the GSV.

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