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Medium and long-term outcomes of endovenous treatment of varicose veins with a 1940nm diode laser: critical analysis and technical considerations

Abstract

Background

Introduction of the endovenous laser technique for treatment of varicose veins triggered a efforts to identify an ideal wavelength, capable of producing the highest possible selective damage with the greatest safety and lowest incidence of adverse effects.

Objectives

Assess medium to long term results of 1940nm diode laser treatment of varicose veins, correlating parameters used with durability of the anatomic outcome.

Methods

This was a retrospective study of patients diagnosed with Chronic Venous Insufficiency at clinical stages CEAP C2 to C6 who underwent thermoablative treatment of trunk varicose veins using a 1940nm wavelength laser with a radial emission optical fiber, from April 2012 to July 2015. A systematic review was conducted of electronic medical records to obtain demographic and clinical data, including postoperative follow-up duplex ultrasound findings.

Results

The average age of the 41-patient sample was 53.3 years and 37 patients were women (90.2%). The average follow-up time was 803 days. The average caliber of the treated veins was 7.8 mm. The immediate success rate was 100% with an average LEED of 45.3 J/cm. The late success rate was 95.1%, and two recanalizations were observed around 12 months after ablation. There was no recanalization in veins treated with a LEED greater than 30 J/cm.

Conclusions

The 1940nm laser proved to be safe and effective in venous segments up to 10 mm in diameter, with the parameters proposed, over medium to long term time follow-up.

Keywords:
laser; varicose veins; endovenous ablation; thermoablation

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