title: Endovenous laser ablation of incompetent perforating veins with 1470 nm, 400 μm radial fiber.
abstract: OBJECTIVE
  To evaluate the efficacy of endovenous laser ablation (EVLA) of incompetent perforating veins (IPVs) with 1470 nm laser with 400 μm radial fiber.
  
  
  BACKGROUND
  EVLA for perforating veins can be performed with insignificant postprocedural morbidity. This allows treatment to be offered to elderly patients with comorbidities that would preclude anesthesia for surgical treatment or subfascial endoscopic perforator surgery (SEPS).
  
  
  METHODS
  A total of 24 perforating veins in 16 limbs of 13 patients were treated between July 2010 and December 2011 in our clinic. Follow-up duplex scans were performed at 1 week and 1, 3, 6, and 12 months after the procedure, to determine the treatment outcome.
  
  
  RESULTS
  Of the 23 treated IPVs, 20 (86.9%) were occluded on the duplex examination at 12 months. The average energy administrated per perforating vein treated was 174 J (range 105-236 J). Four of five ulcers had healed after 8 weeks in clinical-etiology-anatomy-pathophysiology (CEAP) C6 group. Two patients reported localized paresthesia, which subsided spontaneously, but no deep venous thrombosis or skin burn was observed. All components of the Venous Clinical Severity Score (VCSS) demonstrated significant improvements at each postprocedural visit (p<0.001 for all), except for pigmentation and compression, which exhibited variation throughout the follow-up period.
  
  
  CONCLUSIONS
  Especially in the case of liposclerotic or ulcerated skin in the affected region, EVLA of IPVs with 1470 nm diode laser is highly effective and safe, and appears to be feasible. Additionally, repeat treatment can easily be performed should recurrence of IPVs arise.
authors.affiliation: Department of Cardiovascular Surgery, Memorial Atasehir Hospital, Istanbul, Turkey. mdumantepe@gmail.com
authors.forename: Mert
authors.initials: M
authors.lastname: Dumantepe
authors.forename: Arif
authors.initials: A
authors.lastname: Tarhan
authors.forename: Ilhan
authors.initials: I
authors.lastname: Yurdakul
authors.forename: Azmi
authors.initials: A
authors.lastname: Ozler
mesh_terms: D000328:Adult; D000368:Aged; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006801:Humans; D053685:Laser Therapy; D007871:Leg Ulcer / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014689:Venous Insufficiency / Q000601:surgery*; D014945:Wound Healing