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Progress in Endovenous Pulsed Laser Ablation
摘要： Continuous-wave (CW) lasers have been commonly used for endovenous laser ablation (EVLA). However, as some undesired side effects such as postoperative pain and bruising occasionally happens, longer laser wavelength and specially-fabricated laser fibers have been developed. On the other hand, the pulsed-wave (PW) laser, which has a heat production control by thermal relaxation, is independently developed for EVLA. This article discusses the implication of PW laser in EVLA from a theoretical point of view and a newly-developed micropulsation (MP) is introduced as a new concept. Since the MP yields adequate blood and vein wall heat degeneration by microseconds laser emission, efficacy and safety are improved compared with CW laser or conventional PW laser. Initial clinical outcome is favorable and promising for painless EVLA using inexpensive bare fiber.
关键词： varicose vein,thermal relaxation time,micropulsation,endovenous laser ablation,clear tip mode
更新于2025-09-23 15:19:57
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Endovenous Laser Ablation Combined with Stripping Technique for Large Saphenous Varicose Veins: The Selection of Operation Technique
摘要： Objective: Saphenous varicose veins can be accomplished by various operative techniques that result in stripping, ablation, or ligation of the venous reflux section. Great saphenous vein (GSV) stripping is one of the standard operations for varicose veins to eliminate reflux of the sapheno-femoral junction. The goal of any treatment regimen is to eliminate the junctional varicose reflux to control congestive dysfunction. Endovenous laser ablation (EVLA) is safe and effective with less postoperative pain, bleeding, and peripheral nerve damage than open surgery. In this study, a patient with severe progression of primary saphenous varicose veins is presented. We report the outcome of combined surgical strategy and perioperative treatment for extremely swollen varicose veins of the lower limbs to improve leg symptoms and congestion and/or promote skin ulcer healing. Materials and Methods: The subjects included 42 patients (51 limbs) who underwent EVLA with stripping. The patients comprised 24 males and 18 females, who presented a maximum GSV diameter >15 mm. The Clinical-Etiological-Anatomic-Pathophysiologic classification identified 9, 20, 9, 2, 6, and 5 limbs with C2, C3, C4a, C4b, C5, and C6, respectively, among the 42 patients. Results: EVLA was used to treat GSV with a mean length of 16.1±2.8 cm. The mean of the maximum GSV diameter was 16.8±3.2 mm (14.6–21.8 mm). The preoperative visual analog scale (VAS) score was 82.1±12.1. After operation, the VAS gradually deteriorated to 31.3±17.9 (p<0.0001), 2.8±3.6 (p<0.0001), and 1.2±1.8 (p<0.0001) in 7 days, 1 month, and 3 months, respectively. Conclusion: We obtained a satisfactory outcome from our combined strategy and perioperative treatment for extremely swollen saphenous varicose veins. This approach may show the possibility that lower saphenous varicose veins can induce cosmetic and minimally invasive ameliorated intervention to avoid late-phase incompetent perforating veins.
关键词： endovenous laser ablation,stripping,varicose vein
更新于2025-09-12 10:27:22