Document Detail


1470 nm diode laser for endovenous ablation (EVLA) of incompetent saphenous veins - a prospective randomized pilot study comparing warm and cold tumescence anaesthesia.
MedLine Citation:
PMID:  20737384     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Major side effects after endovenous laser ablation (EVLA) are pain and bruising. Low temperature of the tumescence fluid might cause additional venous constriction and a cooling effect around the vein. The aim of this study was to show outcome and side effects after EVLA of incompetent great saphenous veins (GSV) with a 1470 nm Diode laser (Ceralas E, biolitec) using cold or warm tumescence fluid for anaesthesia.
PATIENTS AND METHODS: Between August and November 2007, 85 consecutive patients (85 legs) with an incompetent GSV were treated by EVLA. The patients were randomized in two groups. In 42 patients (Group A) a warm (37 degrees C) and in 43 patients (Group B) a cold (5 degrees C) tumescence fluid (TF) was used for local anaesthesia in the track of GSV. All patients were re-examined after 1, 10 and 30 days clinically and by duplex for complications and occlusion in the treated vein segment. Patient's satisfaction was assessed on a 0 to 4 points scale.
RESULTS: In each group one patient was lost to follow-up. There was no significant difference concerning gender, age, C of CEAP, BMI or diameter of the treated vein. In Group A a mean of 462 ml TF and in Group B a mean of 428 ml TF were used. In Group A the mean LEED (average linear endovenous energy density) was 114 J / cm and in Group B 115 J / cm. In both groups occlusion of the treated veins was achieved for all patients. The diameter of the GSV at 3 cm below the sapheno-femoral junction shrunk from 1.0 to 0.7 cm in both groups. The modified CEAP clinical score improved in Group A from 2.9 to 0.7 (mean value) and in Group B from 3.0 to 1.1. The mean pain score on a scale from 0 to 4 during day 2 to day 10 was 1.2 in Group A and 1.0 in Group B. At this time patients in Group A took a mean of 3.4 and in Group B 1.7 analgetic tablets. Ecchymoses were rare in both groups (4 in Group A, 7 in Group B).
CONCLUSIONS: In this prospective randomized comparative study the temperature of the tumescence fluid did not influence the occlusion rate when a high LEED was used. In both groups pain and ecchymoses are less frequent in this study with a 1470 nm diode laser than reported in studies with 810-980 nm systems. Cold tumescence fluid reduced pain slightly and reduced the intake of analgetics significantly.
Authors:
Felizitas Pannier; E Rabe; U Maurins
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  VASA. Zeitschrift für Gefässkrankheiten     Volume:  39     ISSN:  0301-1526     ISO Abbreviation:  VASA     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-25     Completed Date:  2010-10-05     Revised Date:  2012-10-19    
Medline Journal Info:
Nlm Unique ID:  0317051     Medline TA:  Vasa     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  249-55     Citation Subset:  IM    
Affiliation:
Department of Dermatology, MUMC+ Maastricht, Maastricht, the Netherlands. felizitas.pannier@googlemail.com
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adult
Anesthetics, Local / administration & dosage*
Cold Temperature*
Ecchymosis / etiology
Female
Hot Temperature*
Humans
Injections
Laser Therapy / adverse effects,  instrumentation*
Lasers, Semiconductor*
Latvia
Male
Middle Aged
Pain Measurement
Pain, Postoperative / etiology
Patient Satisfaction
Pilot Projects
Prospective Studies
Recovery of Function
Saphenous Vein / surgery*,  ultrasonography
Severity of Illness Index
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Duplex
Venous Insufficiency / surgery*,  ultrasonography
Chemical
Reg. No./Substance:
0/Anesthetics, Local

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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