New wavelength for the endovascular treatment of lower limb venous insufficiency. 2009

J E Soracco, and J O López D'Ambola
Phlebology Private Centre, Buenos Aires, Argentina. jsoracco@fibertel.com.ar

OBJECTIVE The aim of this research was to show the efficacy of the 1 470-nm wavelength diode laser for endovenous laser treatments and the clinical results obtained. METHODS Patients with varicose veins stratified by CEAP classification (clinical) in C2-6 and low-flow venous malformations were treated with and without crossectomy. Endolaser venous system with Ceralas E 1 470 nm diode laser (ELVeS PainLess, Biolitec AG, Jena, Germany) was used. The average power applied was in the range of 2-6 W, continuous mode and pull-back of 10 mm/5 s. Two optical fibres were used; frontal emission bare fibre of 400 micro (ELVeS) and radial emission fibre of 600 micro (ELVeS). All patients were evaluated with Duplex ultrasonography (US) before, intraproceeding, immediately after, at 48 hours, 7 and 30 days after the initial procedure. An average follow-up of twelve months was attained. In 15% of the cases, the endovenous laser proceeding was also evaluated during the treatment with thermographic images, direct thermography and direct venous angioscopy to assess the local temperature increase. After the treatment histopathological studies were also performed. RESULTS Between 30% and 50% of the vein's initial diameter was immediately reduced in 100% of patients and fibrosis was observed by histopathological analysis. Thirty days post-treatment all cases presented venous obliteration observed by Duplex US. Clinical symptoms were resolved. Side-effects were: minimal discomfort, local pain, postpuncture ecchymosis and minimal fibrosis of the treated veins. Nevertheless, there was absence of hyperpigmentation in all patients and absence of neuritis in 98.6% of patients. Popliteal thrombosis was presented 24 hours after the procedure in 2.9% of the patients (these patients did not receive heparin). CONCLUSIONS With this laser wavelength, which is new in phlebology applications, remarkable effective results were achieved with lower power comparing to the results currently obtained by using higher power and shorter laser wavelengths. This development provides the benefit of potentially better therapeutic results with less collateral damage.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D001118 Argentina Country located in southern South America, bordering the South Atlantic Ocean, between Chile and Uruguay.
D013817 Thermography Imaging the temperatures in a material, or in the body or an organ. Imaging is based on self-emanating infrared radiation (HEAT WAVES), or on changes in properties of the material or tissue that vary with temperature, such as ELASTICITY; MAGNETIC FIELD; or LUMINESCENCE. Temperature Mapping,Mapping, Temperature,Mappings, Temperature,Temperature Mappings

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