Innovative treatments in chronic venous insufficiency: endovenous laser ablation of perforating veins: a prospective short-term analysis of 58 cases

R J Hissink, R M G Bruins, R Erkens, M L Castellanos Nuijts, M van den Berg
European Journal of Vascular and Endovascular Surgery 2010, 40 (3): 403-6

OBJECTIVE: To evaluate the efficacy of endovenous laser ablation of incompetent perforating veins.

STUDY DESIGN: Prospective cohort study.

PATIENTS: A total of 58 perforating veins in 33 limbs of 28 patients were treated between March 2008 and February 2009 in an outpatient clinic setting. The average age was 65 years (range 30-81 years); 64% female; CEAP clinical stage C4 (67%), C5 (17%) and C6 (16%) (Clinica, Etiology, Anatomy and Pathophysiology, CEAP).

METHODS: All patients underwent a standardised clinical examination and duplex ultrasonography. Guided by duplex ultrasonography, the perforating veins were cannulated percutaneously and tumescent local anaesthesia was given. An 810-nm diode laser was used to deliver 14 W power. Mean total energy delivered was 187 (range 87-325) J. Three months post-treatment, all patients underwent a further duplex ultrasound examination, to determine the treatment outcome.

RESULTS: Occlusion of the perforating veins was achieved after 3 months in 78% of the cases. In the CEAP C6 group, four of five ulcers had healed after 6 weeks. No serious complications, including deep venous thrombosis, were encountered.

CONCLUSIONS: Endovenous laser therapy for treating incompetent perforating veins is a safe and technically feasible technique. The initial occlusion rate is acceptable.

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