Endovascular Recanalization of Chronic Non-malignant Obstruction of the Inferior Vena Cava

70 J/cm) for SSV. The complete occlusion of the treated saphenous vein was defined as absence of flow on color Doppler imaging and was achieved in 174/177 (98.3%) subjects at 4 weeks and 132/135 (97.7) patients at 12 months. Partial occlusion was observed in three patients and was defined as reflux >3 cm distal to the junction. The mean length of non-occluded stump at the junction between saphenous vein and deep vein was 0.5 cm (range 3.6 to 5.0 cm) 4 weeks postoperative. Mean postoperative reduction of the diameter of GSV and SSV at 1 year was 40% and 56% respectively (p< 0.05%). In the early postoperative phase paraesthesia was observed in 15/177 (8.5%), ecchymosis in 4/177 (2.3%), lymphocoele in 1/ 177 (0.6%), hyperpigmentation in 1/177 (0.6%). Endovenous heat induced thrombus (EHIT) propagation was observed in 4/177 (2.3%) subjects. There were no skin burns or phlebitis. No patient reported severe pain. The mean postoperative pain intensity (Visual Analog Scale) was 1.3. The mean convalescence period was 2 days (1e30 d). No long-term complications and recurrent reflux was observed at 1 year follow-up. Conclusion: ELT using Thulium laser (1940 nm) with radial fiber efficiently eliminates the reflux in the saphenous veins by occlusion and significant diameter reduction with no reflux recurrence at 1 year follow up. The complication rates are less or comparable to the other endothermal and surgical procedures. These benefits are offered with low postoperative pain, analgesia requirement and rapid convalescence.