Role of endovenous laser therapy in large and very large diameter great saphenous veins.
BACKGROUND
The literature suggests that endovenous laser is less efficacious in great saphenous veins (GSVs) with a diameter of greater than 1 cm. This paper describes the efficacy of endovenous laser therapy (EVLT) in ablating GSV with a diameter greater than 1.0 cm.


METHODS
Retrospective review of consecutive patients undergoing GSV EVLT between 15 November 2012 and 25 July 2013 was performed. GSV with a maximum diameter of ≥1.0 cm were defined as large, those with a maximum diameter of ≥2.0 cm were defined as very large.


RESULTS
A total of 38 ablations were reviewed; two patients had bilateral GSV vein ablations. All underwent a 6-week post-procedural duplex. There were 20 ablations on veins >1 cm and 4 ablations on veins ≥2.0 cm. Median GSV length was 21.5 cm (16.5 cm for <1 cm, 24.5 cm for 1-2 cm and 24.5 cm for >2 cm). When correcting for length of vein treated, the energy deposited was stable for all patients at 80 J/cm. Tumescent volumes per centimetre were 3.7 mL/cm for veins <1.0 cm and 4.6 mL/cm for veins >1.0 cm. Successful ablation was achieved in 100% of veins independent of size.


CONCLUSIONS
Ablation rates for large and very large GSVs in our series do not differ from the cohort of patients with GSV < 1.0 cm and from published results for GSVs < 1.0 cm. This supports the use of EVLT for venous insufficiency in the larger diameter GSV typically found in patients on public hospital waiting lists.
Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia.
Cosmin
C
Florescu
Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia.
Greg
G
Curry
Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia.
Timothy
T
Buckenham
D000328:Adult; D000368:Aged; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000175:diagnosis / Q000601:surgery*
laser; varicose vein