Endovenous laser treatment of the small [corrected] saphenous vein: efficacy and complications.
OBJECTIVE
The study was conducted to assess the efficacy and rate of complications of endovenous laser treatment (EVLT) of the short saphenous vein (SSV).


METHODS
During a 17-month period, 210 (187 patients) with SSV incompetence documented by duplex ultrasound studies were treated with EVLT using a 980-nm diode laser. Duplex ultrasound examinations were performed on the day of the procedure, within the first week, and 2 to 11 months after the procedure (mean follow-up, 4 months). Clinical examinations were performed at 2 weeks and 6 weeks. Patients were assessed for deep venous thrombosis (DVT), nerve injury, and resolution of symptoms.


RESULTS
All procedures were technically successful, and in the 126 patients (60%) who completed final follow-up scanning, 96% of SSVs remained closed. Three patients (1.6%) had numbness at the lateral malleolus at the 6-week follow-up. DVT, defined as a tail of thrombus protruding into the popliteal vein, was not detected in any limbs at the initial duplex study, but was noted in 12 limbs (5.7%) at the 1-week follow-up examination. Nine patients were treated with 3 days to 3 months of fractionated heparin and Coumadin (Bristol-Myers Squibb, Princeton, NJ), and there were no DVT extensions or pulmonary emboli. The anatomic configuration of the saphenopopliteal junction was the only factor predictive of DVT.


CONCLUSIONS
Intermediate-term results of EVLT of the SSV demonstrate that the technique is effective at eliminating SSV reflux and affording symptomatic relief. The incidence of nerve injury is low, but the incidence of DVT is higher than reported for the great saphenous vein. Anatomic features of the SSV may predict patient risk for DVT.
Gibson
Kathleen D
KD
Lake Washington Vascular Surgeons, Bellevue, WA 98004, USA. drgibson@lkwv.com <drgibson@lkwv.com>
Ferris
Brian L
BL
Polissar
Nayak
N
Neradilek
Blazej
B
Pepper
Daniel
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013997:Time Factors; D020196:Trauma, Nervous System / Q000453:epidemiology / Q000209:etiology*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D014861:Washington / Q000453:epidemiology