The heat-pipe resembling action of boiling bubbles in endovenous laser ablation.
Endovenous laser ablation (EVLA) produces boiling bubbles emerging from pores within the hot fiber tip and traveling over a distal length of about 20 mm before condensing. This evaporation-condensation mechanism makes the vein act like a heat pipe, where very efficient heat transport maintains a constant temperature, the saturation temperature of 100 degrees C, over the volume where these non-condensing bubbles exist. During EVLA the above-mentioned observations indicate that a venous cylindrical volume with a length of about 20 mm is kept at 100 degrees C. Pullback velocities of a few mm/s then cause at least the upper part of the treated vein wall to remain close to 100 degrees C for a time sufficient to cause irreversible injury. In conclusion, we propose that the mechanism of action of boiling bubbles during EVLA is an efficient heat-pipe resembling way of heating of the vein wall.
van der Geld
Cees W M
CW
Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. C.W.M.v.d.Geld@tue.nl
van den Bos
Renate R
RR
van Ruijven
Peter W M
PW
Nijsten
Tamar
T
Neumann
H A Martino
HA
van Gemert
Martin J C
MJ
D055592:Biophysical Phenomena; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D008954:Models, Biological; D013814:Thermal Conductivity; D013816:Thermodynamics; D014680:Veins / Q000601:surgery; D014689:Venous Insufficiency / Q000601:surgery