Summary. Purpose: improvement of postoperative dynamics in patients after endovenous laser ablation (EVLA) using high-intensity laser therapy (HILT). Materials and methods. The study included 54 patients who noted a moderately painful stretch on the thigh along the course of the coagulated great saphenous vein after EVLA. Patients were divided into 2 groups: the first group (n=28) used HILT, the second group (n=26) was a control group. The effectiveness of the treatment was evaluated by the patient’s subjective assessment of his condition, objective examination of the local status, visual analog scale of pain (VAS) and ultrasound monitoring of changes in the coagulated vein. Research results. After 2 weeks, pain decreased by 62.2% in patients of the first group, by 28.6% in the second group (p <0.05). Compared to the results at the time of application, the vein diameter decreased by 29.9% in the first group, and by 19.4% in the second group. Conclusions. The use of HILT in patients of the first group in the post-operative period of EVLA allows to reduce the severity of pain by 33.6%, and also to speed up the lysis of coagulated great saphenous vein on the thigh by 10.5%, compared to the second group. The results of this study can be used in clinical practice to add HILT as another non-invasive option to improve postoperative dynamics in patients after EVLА.
Introduction. Superficial vein thrombosis is characterized by the formation of thrombi in the superficial veins with subocclusion or occlusion of the venous lumen and its inflammatory reaction, which occurs more often in the lower extremities. Chronic venous disease in 75–88% of cases is the most important clinically identified factor in the development of superficial vein thrombosis. The great saphenous vein is affected in 60–80% of cases. A population-based study found that the chronic venous disease is a risk factor for venous thromboembolism and correlates with an increased risk of mortality in patients. Venous thromboembolism is a major burden of the disease worldwide, with approximately 10 000 000 cases per year. Objective: to assess the prevalence of superficial vein thrombosis in patients with chronic venous disease and to identify the relationship between the diameter of the great saphenous vein and superficial vein thrombosis. Materials and methods. Total of 925 chronic venous disease cases were analyzed from January 2019 to December 2021 at the Clinical Department of Surgery, Traumatology, Orthopedics, and Phthisiology of Sumy State University (Sumy Laser Clinic, LLC) for the prevalence of superficial vein thrombosis in patients with chronic venous disease who were undergoing treatment. The patients with superficial vein thrombosis were examined for the diameters of great saphenous vein and venous reflux using ultrasound 10 mm below the sapheno-femoral junction, in the upper and lower thirds of the thigh. Results: Of 925 chronic venous disease cases, superficial vein thrombosis was observed in 53 cases, which accounted for 5.73 % of the total. Women accounted for 67.9 % (36), men – for 32.1 % (17). The study included patients aged 25 to 69 years (mean age 52.62 ± 10.48 years). In 69.8 % (37) of superficial vein thrombosis cases, the diameter of great saphenous vein was ≥ 10 mm at a level 10 mm below the sapheno-femoral junction; in 49 % (26) of cases – in the upper third of the thigh; in 30.2 % (16) of cases – in the lower third of the thigh. That is, the extension of the sapheno-femoral junction trunk to the lower third of the thigh was preserved in 43.24% of cases. Conclusion. The results of the study revealed a high prevalence (5.73%) of superficial vein thrombosis. 69.8% of all cases of superficial vein thrombosis was registered in patients with a large diameter (≥ 10 mm) of great saphenous vein.
Aim: To compare pathomorphological changes in the venous wall of large diameter great saphenous veins (GSV) after endovenous laser ablation (EVLA) using wavelengths of 1470 nm and 1940 nm. Materials and Methods: We studied 120 specimens of great saphenous veins from 30 patients with chronic venous disease with large-diameter (>1 cm). Patients were randomly divided into two groups. The 1st group received EVLA using wavelengths of 1470 nm, the 2nd group received EVLA using wavelengths of 1940 nm. Four specimens were taken at the level of the lower third of the thigh after laser coagulation in each patient. Vein specimens were processed for histological studies. Both qualitative and quantitative analyses were performed to assess the degree of wall changes. Results: The share of satisfactory results when using 1470 nm laser wavelengths is 83.3%, while when using 1940 nm laser wavelengths this result is 93.3%. When using both wavelengths of laser irradiation with a GSV diameter of more than 1 cm, no unsatisfactory results are observed. Conclusions: Obtained in our study data confirmed efficacy of the 1470 and 1940 nm endovenous laser ablation in the treatment of the large size GSV (more than 10 mm). Histological exams show preferability in the 1940 nm EVLA versa 1470 nm, considering the excellent result in the uniformity of distribution and safety in the deepness of the thermal injury.
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