Endovenous Laser Treatment of the Small Saphenous Vein with a 980-nm Diode Laser: Early Results

Abstract

Taking into account the high failure rates of incompetent SSV surgery and the anatomic complexity of SPJ, the endovenous 980-nm diode laser surgery is a safe and effective, cosmetically preferential procedure while a long-term follow-up is being awaited.

Endovenous laser treatment for uncomplicated varicose veins

“…Case series of EVLA with one to three year duplex follow-up have reported truncal vein ablation rates of 93–99%, 4,23,48,54,57 with most recanalizations appearing within the first year.…”

“…Although EVLA was initially used to treat GSV reflux there are several large series describing successful SSV 4–7 and anterior saphenous vein ablation. 8,9 There are also isolated reports of treatment of incompetent perforating veins 10,11 and varicosities themselves.…”

Mechanochemical Endovenous Ablation of Small Saphenous Vein Insufficiency Using the ClariVein® Device: One-year Results of a Prospective Series

“…In published data, transient sural nerve injury caused by ELVA varies between 1.3% and 11%. 6,11,14,19 In redo SSV surgery, the incidence of numbness 1 year after treatment is as high as 28%. 20 In general, major complications, such as skin burns, DVT and pulmonary embolism after EVLA, seldom occur (<1%).…”

The surgical anatomy of the small saphenous vein and adjacent nerves in relation to endovenous thermal ablation

“…(3) and (5). Yellow: bony landmarks; the most lateral (1) and most medial (2) part of the tibia plateau, the proximal (3) and distal (5) border of the lateral malleolus, the proximal border of the medial malleolus (4), the insertion of the Achilles tendon (6), the tuberosity of the fifth metatarsal (7), and the tuberosity of the first metatarsal (8). Green: nonbony landmarks, halfway between landmarks 1 and 2, at one-third (9) and two-thirds (10) between landmarks 1 and 3, and at one-third (11) and two-thirds (12) between landmarks 2 and 4.…”

“…Short-term and midterm results are promising and show low recurrence rates and fewer complications with EVA than with conventional surgery. [6][7][8][9] Nevertheless, no consensus has been reached regarding the surgical anatomic landmarks for a safe approach of the SSV.…”