IntroductionEndovenous microwave ablation (EMA) is a relatively novel thermal ablation treatment for great saphenous vein (GSV) varicosis, and its efficacy and safety are rarely reported. This study aims to explore whether EMA can be comparable to endovenous laser ablation (EVLA), which is a widely used thermal ablation treatment in clinical practice.Methods and analysisThis is a multicentre, randomised controlled non-inferiority trial to compare the efficacy and safety of EMA and EVLA in patients with GSV varicosis. We will recruit 180 patients in 6 centres and randomly assign them into treatment group (EMA group) and control group (EVLA group) in a 1:1 ratio. The patients will return to the hospitals at 7 days, 3 months, 6 months and 12 months, and will be called at 1 month after the treatment for follow-up visits. The primary outcome is the occlusion rate of GSV immediately, at 6 months, and at 12 months after the treatment. The secondary outcomes are Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ) Score, operation time and instrument performance evaluation.Ethics and disseminationThis protocol has been approved by the Clinical Trial Ethics Committee of Beijing Hospital (2020BJYYEC-126–02), Peking Union Medical College Hospital (KS2020393), Beijing Tsinghua Changgung Hospital (No.20279-2-02), Beijing Luhe Hospital.Capital Medical University (2020-LHYW-030–01), the First Hospital of Hebei Medical University (No.2020249), and the First Affiliated Hospital of Xi’an Jiaotong University (XJTU1AF2021LSY-12). The trial results will be published in peer-reviewed journals.Trial registration numberNCT04726124.
The burst‐mode femtosecond laser has the potential to be a novel thrombus removal technique. This paper proposed to investigate the mechanism of thrombus ablation in vitro by burst‐mode femtosecond laser. A simulation model of the interaction between femtosecond laser and thrombus was established. An in vitro thrombus model was prepared. Combined with the high‐speed galvanometer and femtosecond laser, the ablation experiments in vitro were performed. The experimental results showed that the ablative threshold was 0.27 times and the efficiency was about 1.4 times of burst‐mode femtosecond laser as those of traditional mode femtosecond laser. These phenomena were related to the residual temperature and free electrons on the thrombus surface, which confirmed the simulating results and had relationship with incubation effects. The high ablative efficiency and safety of burst‐mode femtosecond laser for thrombus ablation were verified, which may help to achieve the femtosecond pulse output through flexible fiber easily and stably. The burst‐mode femtosecond laser represents an important technological advancement of the method in terms of endovascular treatment with femtosecond laser.
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