Endovenous laser ablation (EVLA) performed with 1470 nm laser: long term outcomes and comparison with 980 nm laser

Purpose To determine the effectiveness of EVLA of symptomatic lower extremity varicosities with 1470 nm laser fiber, and to compare the effectiveness to EVLA with 980 nm laser fiber. Materials and Methods IRB and HIPAA compliance were obtained. A retrospective review of electronic medical records of patients who underwent EVLA with 1470 nm laser at a busy outpatient interventional radiology practice associated with a major medical center was performed. Data collected included age, sex, laterality, vein treated, and parameters of treatment—i.e. watts, length of vein treated, energy density (J/cm), and tumescent anesthesia volume. Follow up duplex Doppler ultrasound exam results and follow up intervals were recorded. Ultrasound recanalization was defined as compressibility of and/ or presence of color Doppler flow within the treated vein segment. Fisher's exact test was used to compare the recanalization rate of the 1470 nm wavelength group to those treated with 980 nm EVLA during the same time period. Results Between 9/2009 and 4/2012, 74 vein segments were treated with 1470 nm wavelength EVLA. The distribution of vein segments was 47 (63.5%) great saphenous vein (GSV), 13 (17.6%) small saphenous vein (SSV), 10 (13.5%) accessory lateral tributary (ALT), and 4 (5.4%) other. The average US follow-up duration was 215 days (range: 7 - 1022). Recanalization rate for 1470 nm group was 5.4% (4/74). During the same time period at the same center, there were 714 vein segments treated with 980 nm wavelength EVLA. The average US follow-up duration was 310 days (range: 7 - 776). The recanalization rate was 3.5% (25/714).There was no statistically significant difference in long term recanalization rates between those treated with 1470 nm laser compared with 980 nm EVLA (p=0.34). Conclusion EVLA performed with 1470 nm laser showed a low long term recanalization rate. There was no statistically significant difference in recanalization rate compared with segments treated with 980 nm EVLA during the same time period.