Document Detail


Endovenous laser therapy in the treatment of lower-limb venous ulcers.
MedLine Citation:
PMID:  20430295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess the efficacy of endovenous laser therapy (EVLT) in the treatment of lower-limb venous ulcers secondary to venous reflux. MATERIALS AND METHODS: Forty-four of 139 patients referred for EVLT from January 2004 to August 2007 had nonhealing venous ulcers. Preprocedural duplex ultrasound (US) was performed to document saphenous venous reflux secondary to saphenofemoral/saphenopopliteal junction incompetence, deep venous insufficiency, and deep vein thrombosis. Follow-up intervals were within 1 week, monthly until ulcer healing, and every 6 months thereafter. Mean follow-up period was 35.8 months (range, 8.1-59.3 months). RESULTS: Mean great saphenous vein (GSV) diameter and length treated were 9.9 mm (range, 5.5-16.0 mm) and 36.7 cm (range, 20.0-60.0 cm). Mean laser energy used was 3,292 J (range, 1,392-4,971 J). Mean energy deposited per centimeter of vein was 93.6 J/cm (range, 45.2-182.0 J/cm). Mean laser time was 232 seconds (range, 99-347 sec). Fifteen patients with follow-up duplex US had no GSV flow at 6 months, with nonvisualization indicating complete obliteration. Ulcer healing occurred as early as 1 week after the procedure in some patients. Cumulative healing rates at 1, 3, 6, and 12 months were 82.1%, 92.5%, 92.5%, and 97.4%, respectively. No ulcer had recurred at 1 year, but ulcers recurred in five patients at 14, 14, 23, 35, and 52 months after EVLT, respectively. One patient with a nonhealing ulcer 2 years after treatment developed well differentiated squamous cell carcinoma. CONCLUSIONS: Ulcer epithelization occurred with continued GSV occlusion and loss of flow. Most ulcers healed within 3 months with no recurrence at 1 year. Nonhealing ulcers should undergo biopsy to exclude malignant transformation.
Authors:
Terence Kiat Beng Teo; Kiang Hiong Tay; Shueh En Lin; Seck Guan Tan; Richard H Lo; Manish Taneja; Farah G Irani; Mathew George Sebastien; Kiat Hon Lim; Bien Soo Tan
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  21     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  657-62     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore. tkbteo@yahoo.com.sg
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Laser Therapy / methods*
Male
Middle Aged
Saphenous Vein / surgery*
Treatment Outcome
Varicose Ulcer / surgery*

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


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