Endovenous laser ablation (980 nm) of the small saphenous vein in a series of 147 limbs with a 3-year follow-up.
OBJECTIVE
This study aims to demonstrate the treatment outcomes of endovenous laser ablation (EVLA) of incompetent small saphenous veins (SSVs) with a 980-nm diode laser.


METHODS
Between 1 June 2003 and 30 June 2006, 128 patients (147 limbs) with varicose veins and reflux in the SSV on duplex ultrasound (US) examination were treated with a 980-nm diode laser under US guidance. EVLA was performed using pulsed mode with a power of 10W. The pulse duration (1.5-3 s) was chosen to deliver a linear endovenous energy density (LEED) depending on the SSV diameter measured 1.5 cm below the sapheno-popliteal junction (SPJ) with the patient standing. For SSV diameters between 2 and 4.5mm, the LEED applied was 50 Jcm(-1). The LEED was 70 Jcm(-1) for 4.5-7 mm, 90 Jcm(-1) for 7-10mm. Patients were evaluated at 1-week, 1-month, 1-year, 2-year and 3-year follow-up.


RESULTS
The initial technical success rate was 100% in 147 patients. The SSV remained closed in 114 of 117 limbs (97%) after 1 year, all of 61 limbs after 2 years and all of 30 limbs after 3 years. For the three SSVs where re-canalisation was observed, the diameter was greater than 9 mm. Major complications have not been detected and, in particular, there was no deep venous thrombosis (DVT). Ecchymoses were seen in 60% with a median duration of 2 weeks. Temporary paraesthesia (mostly hypoaesthesia) was observed in 40% of treated legs with a median duration of 2 weeks. The maximum duration did not exceed 4 weeks. No skin discolouration, superficial burn, thrombophlebitis or palpable induration was observed.


CONCLUSIONS
EVLA of the incompetent SSV with a 980-nm diode laser appears to be an extremely safe technique. After successful treatment, there is a very low rate of re-canalisation of the SSV. Obliteration of the SSV was confirmed at 1-, 2- and 3-year follow-up; this study suggests that this procedure will provide a lasting result.
Desmyttère
J
J
S.E.L. Angéio-Phlébo Interventionnelle, Lomme, France.
Grard
C
C
Stalnikiewicz
G
G
Wassmer
B
B
Mordon
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D018475:Head-Down Tilt; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D054023:Lasers, Semiconductor; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult