BACKGROUND: Until now, endovenous laser treatment (ELT) of the lesser saphenous vein (LSV) has not been reported. OBJECTIVE: To evaluate efficacy and side effects for ELT of the LSV. METHOD: Otherwise unselected patients with an incompetent LSV were included. After perivenous infiltration of tumescent local anesthesia, laser energy (940 nm) was administered endovenously, either in a pulsed fashion or continuously during constant backpull of the laser fiber. Patients were scheduled for duplex follow-up at Day 1 and also at 1, 3, 6 and 12 months, postoperatively. RESULTS: Forty-one LSVs were targeted in 33 patients with a median age of 66 years (range, 35 to 93). Seventy-three percent of patients had skin changes (C4). Thirty-six percent had an open or healed venous ulcer (C5,6) and 15% a postthrombotic syndrome (ES AS,D PR). Thirty-nine LSVs (95%) completed ELT successfully. During a median follow-up interval of 6 months (range, 3 to 12 months), no recanalization event could be observed. Apart from one thrombosis of the popliteal vein in a patient with polycythemia vera, only minor side effects, particularly no permanent paresthesia, could be observed. CONCLUSION: ELT of the LSV under tumescent local anesthesia is feasible and effective. Caution is warranted with ELT of thrombophilic patients.
BACKGROUND: Until now, endovenous laser treatment (ELT) of the lesser saphenous vein (LSV) has not been reported. OBJECTIVE: To evaluate efficacy and side effects for ELT of the LSV. METHOD: Otherwise unselected patients with an incompetent LSV were included. After perivenous infiltration of tumescent local anesthesia, laser energy (940 nm) was administered endovenously, either in a pulsed fashion or continuously during constant backpull of the laser fiber. Patients were scheduled for duplex follow-up at Day 1 and also at 1, 3, 6 and 12 months, postoperatively. RESULTS: Forty-one LSVs were targeted in 33 patients with a median age of 66 years (range, 35 to 93). Seventy-three percent of patients had skin changes (C4). Thirty-six percent had an open or healed venous ulcer (C5,6) and 15% a postthrombotic syndrome (ES AS,D PR). Thirty-nine LSVs (95%) completed ELT successfully. During a median follow-up interval of 6 months (range, 3 to 12 months), no recanalization event could be observed. Apart from one thrombosis of the popliteal vein in a patient with polycythemia vera, only minor side effects, particularly no permanent paresthesia, could be observed. CONCLUSION: ELT of the LSV under tumescent local anesthesia is feasible and effective. Caution is warranted with ELT of thrombophilicpatients.
Authors: Doeke Boersma; Ramon R J P van Eekeren; Hans J C Kelder; Debora A B Werson; Suzanne Holewijn; Michiel A Schreve; Michel M P J Reijnen; Jean Paul P M de Vries Journal: Trials Date: 2014-10-29 Impact factor: 2.279