Effectiveness of endovenous laser treatment in eliminating superficial venous reflux

Abstract

Endovenous laser treatment is a highly effective procedure for eliminating superficial venous reflux in varicose veins selected for treatment when sufficient 810 nm (Diomed, Inc.) laser energy is utilized.

The ox-foot-model for investigating endoluminal thermal treatment modalities of varicosis vein diseases

“…Endoluminal laser assisted treatment of varicosis veins in a clinical situation was started using the bare fiber technique, applying 8 W laser energy spot-wise at 3 mm intervals (Navarro et al, 2001). this procedure results in perforation of the vein wall, as shown in Figure 3A, which correlates with clinical side effects reported, such as hematomas (Elmore and Lackey., 2008;Luebke and Brunkwall, 2008). In comparison, using the endoluminal RFtechnology (Closure Plus, VNUS-Medical Technology GmbH, Weinstadt, Germany) on the OFM, a whitish colored coagulated vein can be observed without signs of perforation or charring, as shown in Figure 3B (Beck et al, 2007;Blagova et al, 2007).…”

Endovenous laser therapy – application studies and latest investigations

“…There have, however, occasionally been reports on series and multi-center studies with more than 500 treatments and post-operative observation periods of more than 60 months [9,12,[15][16][17][18]. Today, there are data from more than 60 publications with altogether more than 15,000 ELT treatments available which are summarized and evaluated in overviews [19].…”

“…This is the only way LEED and EFE can be calculated for every treatment, thereby making it possible to compare clinical results with different treatment protocols. Clinical analyses suggest that failures in therapy with non-occlusion or recanalization after ELT treatment are observed less when suf-ficiently high-energy density is used -compared to lower LEED or EFE [5][6][7][8][9][10][11][12]. On the other hand, energy densities above a certain level can lead to side effects such as transmural ablation, perforations and alteration of perivenous tissue [13,14].…”

“…The lumen is usually reduced and filled with strongly echoing thrombus material. In the remainder of the vein's path, as a result of repair and scar formation, a stringy, fibrous change may appear or the vein disappears [12].…”

Iatrogenic Complications Following Laser Ablation of Varicose Veins

“…With the appropriate selection of patients, EVLA treatment can technically be carried out in more than 99 % of the patients. (Elmore, 2008) In a large single center, Myers and Jolley treated 509 limbs with an 810 nm laser during a 5 year period. The rate of primary occlusion at 4 years was 76% and the secondary occlusion rate was 97%.…”