Document Detail


The immediate effects of endovenous diode 808-nm laser in the greater saphenous vein: morphologic study and clinical implications.
MedLine Citation:
PMID:  15944603     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We conducted this study to evaluate the immediate venous morphologic alterations produced in the great saphenous veins by the endovenous diode 808-nm laser used for the treatment of superficial venous insufficiency and varicose veins of the lower limbs and to clarify the clinical implications of the histologic findings.
METHODS: Chosen for the study were 24 limbs of 16 patients with CEAP classification 3 to 6, ultrasound-documented greater saphenous insufficiency, and venous diameters between 3.9 mm and 17 mm (mean, 8.04 mm) without phlebitis, saphenous aneurysms, congenital malformations, or deep venous insufficiency. All limbs underwent surgical saphenofemoral disconnection, and the greater saphenous vein was treated with an endovenous diode 808-nm laser by continuous emission at 8 to 12 W and variable retraction speed (</>1 mm/s). Spinal or local, but not tumescent, anesthesia was used. Twenty-nine specimens (3 to 5 cm long) of 24 proximal greater saphenous and five anterior accessory saphenous veins were excised and studied by light microscopy for diameter and thickness of the venous wall, extent of injury into the intima, media, and adventitia, as well as penetration of thermal damage.
RESULTS: The histologic evaluation showed thermal injury to the intima in all specimens and full-thickness intimal injury in 22 specimens (75%); the average penetration of thermal injury in 29 specimens was 194.40 microm (range, 10 to 900 microm; 14.61% of the mean wall thickness); complete intimal circumference injury occurred in 8 specimen veins <10 mm in diameter (27.5%), full thickness damage in 6 (20.7%), and perforation in 2 (6.9%).
CONCLUSIONS: Saphenous ablation using 808-nm laser by variable retraction speed, combined with saphenofemoral interruption, leads to sufficient vein wall injury to assure venous occlusion. Full thickness thermal injury or perforation is infrequent. Optimal results can be obtained in veins <10 mm in diameter.
Authors:
Leonardo Corcos; Sergio Dini; Dino De Anna; Ovidio Marangoni; Elio Ferlaino; Tiziana Procacci; Tommaso Spina; Mario Dini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  41     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-09     Completed Date:  2005-07-15     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1018-24; discussion 1025     Citation Subset:  IM    
Affiliation:
Postgraduate School of Vascular Surgery, University of Udine, Italy. corcosleonardo.md@virgilio.it
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MeSH Terms
Descriptor/Qualifier:
Humans
Laser Therapy*
Saphenous Vein / pathology,  surgery*
Varicose Veins / pathology,  surgery*
Venous Insufficiency / pathology,  surgery*

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