OUR EXPERIENCE WITH ENDOVENOUS LASER THERAPY FOR VARICOSE VEINS
2010
Background: The surgical management of varicose veins has been
subject to radical change due to both the effective use of
endovenous laser therapy (EVLT) and greater knowledge regarding
the venous haemodynamics of the lower limbs. Aim: The aim of
our study was to evaluate the results of varicose vein
treatment using EVLT. Based on our results we discuss the use
of laser, the appropriate use of crossectomy (a ligation and
dissection of the great saphenous vein and its tributaries),
and deduce the amount of energy required for the occlusion of
treated veins. Method: 326 subjects treated with EVLT using the
810 nm laser. Results were retrospectively evaluated. Patients
were followed-up with Doppler US at 1 and then 3 weeks, and 6
and 12 months post procedure. Results: Long-term complications
were experienced by 11 (3.4%) patients in our subject group
whilst re-canalisation occurred in 12 patients. Complete vein
recanalisation was not detected. Conclusion: Based on our
experience, crossectomy should be performed, although not
routinely, in all patients suffering from varices of the lower
limbs. We find the application of over 40 J of energy per
centimetre of vein length (J/cm) avoids the possibility of
burns. The application of such energy will allow safe occlusion
of the vein with minimal risk of recanalisation and burns.
Before the operation, we recommend the length of the treated
vein be measured in order to deduce the minimum amount of Jules
that should be used for a successful occlusion.
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