Endovenous laser ablation of varicose veins after direct percutaneous puncture: early results.
BACKGROUND
Although endovenous laser ablation has been demonstrated to effectively occlude incompetent saphenous veins, it does not treat branch varicosities directly.


OBJECTIVE
The objective was to evaluate the technical feasibility and early results of the direct ablation of branch varicosities using a 980-nm diode laser.


METHODS
From July to August 2005, 17 patients (21 limbs; male:female ratio, 7:10; mean age, 50.1 years; range, 24-62 years) with varicose veins were enrolled in this study. Endovenous laser ablation was performed in incompetent saphenous veins. Thereafter, branch varicosities were percutaneously punctured and a direct laser ablation was performed using a 400-microm laser fiber. Patients were evaluated at 1 week and at 1-, 3-, and 6-month intervals.


RESULTS
Technical success in branch varicosities was achieved in 11 of 15 limbs (71.4%). Continued closure of treated saphenous veins was evident in 11 of 11 limbs (100%) at 1-month follow-up. Successful ablation in varicose tributaries was seen in 6 of 11 limbs (54.5%) at 1-month follow-up and ablation failed in 5 limbs. One of the 11 limbs (9%) had a skin burn that required treatment.


CONCLUSIONS
Despite partly successful occlusion, we suggest that direct laser ablation cannot replace classic methods of treating branch varicosities, because of its high failure rate and the risk of skin burns.
Park
Sang Woo
SW
Department of Radiology, Konkuk University Hospital, Seoul, Korea.
Yun
Ik Jin
IJ
Hwang
Jae Joon
JJ
Lee
Song Am
SA
Kim
Jun Seok
JS
Chang
Seong-Hwan
SH
Chee
Hyun Keun
HK
Hong
Suk Joo
SJ
D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000473:pathology / Q000601:surgery*