title: Endovenous 808-nm diode laser occlusion of perforating veins and varicose collaterals: a prospective study of 482 limbs.
abstract: BACKGROUND
  Endovenous laser ablation (EVLA) was performed in the treatment of great and small saphenous veins (GSVs, SSVs), perforating veins (PVs), and varicose collaterals (VCs). OBJECTIVE To verify the outcome in PVs and VCs.
  
  
  METHODS
  Four hundred eighty-two limbs of 306 patients were studied. EVLA was performed on 167 GSVs, 52 SSVs, and 534 PVs of 303 limbs and on VCs of 467 limbs; 133 GSVs were stripped, 300 of saphenofemoral junctions (SFJs) and 45 saphenopopliteal junctions (SPJs) were interrupted. Limbs were selected using duplex ultrasound examination and photographs; PVs-VCs diameter (<4 mm) and VC length were measured. EVLA was performed using a 808-nm diode laser, 0.6-mm fibers, continuous emission, 4 to 10 W, and 10 to 20 J/cm. Follow-up on 467 limbs occurred over a mean 27.5 months (range 3 months to 6 years); 98 limbs were followed up for longer than 4 years.
  
  
  RESULTS
  Operating time range from 10 to 30 minutes per limb. Blood vaporization, thrombosis, fibrosis, and atrophy prevailed in PVs and in the large VCs (>4 mm) and massive coagulation in the smaller (<4 mm). High rate of occlusion was seen, with different rates of patent PV-VC mainly in diameter >6 mm. Thirty-nine out of 511 patent PVs (7.6%) and 96 out of 778 VCs (12-13%) were re-treated using EVLA or foam sclerotherapy. Minor complications occurred in 88 of the 778 (11%).
  
  
  CONCLUSIONS
  EVLA of PVs and VCs is effective and faster than surgery in 2- to 6-mm PVs and VCs using an 808-nm diode laser.
authors: Department of Surgical Sciences, Postgraduate School of Vascular Surgery, University of Udine, Udine, Italy. corcosleonardo.md@virgilio.it
authors: Leonardo
authors: L
authors: Corcos
authors: Daniele
authors: D
authors: Pontello
authors: Dino
authors: D
authors: DE Anna
authors: S
authors: S
authors: Dini
authors: T
authors: T
authors: Spina
authors: V
authors: V
authors: Barucchello
authors: F
authors: F
authors: Carrer
authors: B
authors: B
authors: Elezi
authors: F
authors: F
authors: DI Benedetto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D007866:Leg / Q000098:blood supply; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D055815:Young Adult