title: Endovenous ablation of incompetent saphenous veins with a new 1,540-nanometer diode laser and ball-tipped fiber.
abstract: BACKGROUND
  Endovenous laser ablation (EVLA) is an efficient method to treat incompetent saphenous veins with high occlusion rates. The major side effects are postoperative pain and bruising. Laser systems with higher wavelengths, associated with new energy delivery devices, have recently shown excellent short-term results, while reducing the previously reported side effects. The aim of this study is to show the first outcome after EVLA of incompetent saphenous veins with a newly developed ball-tipped fiber and a new wavelength 1,540-nm diode laser.
  
  
  METHODS
  Forty-five incompetent saphenous veins in 35 patients (27 women) were treated: 33 great saphenous veins, 6 short saphenous veins, and 6 anterior saphenous veins. The gravity of chronic venous disease was determined according to the clinical-etiology-anatomy-pathophysiology (CEAP) classification, and the severity of symptoms was scored according to the revised Venous Clinical Severity Score. Patient satisfaction was assessed on a 0-3 scale.
  
  
  RESULTS
  The average linear endovenous energy density was 63.5 J/cm of vein length. Patients returned to daily activities after a mean of 1.7 days (SD: 2) after treatment. The modified CEAP clinical severity score improved drastically from a preintervention mean of 4.9 (SD: 2.6) to 0.17 (SD: 0.38) at day 30. During the follow-up period (mean: 168 days [range: 90-240 days]), all the veins were occluded. All patients except 1 were satisfied or very satisfied with the method. No severe complications occurred. Two patients (5%) developed mild paresthesia in the treated area, which spontaneously resolved after 3 months. Postoperative ecchymoses are frequent (83%). Sixteen patients (43%) experienced pain, but only 5 patients (14%) described it as quite intense and required analgesic therapy.
  
  
  CONCLUSIONS
  EVLA of saphenous veins with a 1,540-nm diode laser using a ball-tipped fiber is a safe and efficient therapy option, with a high success rate in the early postoperative period.
authors.affiliation: Verona Veins Clinic, University of Verona, Verona, Italy. Electronic address: alvise.cavallini@tiscali.it.
authors.forename: Alvise
authors.initials: A
authors.lastname: Cavallini
authors.affiliation: Verona Veins Clinic, University of Verona, Verona, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Marcer
authors.affiliation: Verona Veins Clinic, University of Verona, Verona, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ferrari Ruffino
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D054023:Lasers, Semiconductor; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014689:Venous Insufficiency / Q000175:diagnosis / Q000601:surgery*