title: Endovenous laser ablation of insufficient perforating veins: Energy is key to success.
abstract: OBJECTIVE
  To evaluate the feasibility and anatomical success of endovenous laser ablation (EVLA) of incompetent perforating veins (IPV).
  
  
  METHODS
  All 135 consecutive patients with IPV treated with ELVA (intention-to-treat) from January 2008 to December 2013 were included. Up to the end of 2011, an 810-nm laserset (14 W) was used, and afterwards, a 1470-nm laserset (6 W) was introduced. Duplex ultrasound was performed at 6 weeks' follow-up to assess anatomical success.
  
  
  RESULTS
  Overall anatomical success at 6 weeks' follow-up was 56%. Anatomical success was 63% after treatment with 810 nm and 45% with 1470 nm (p = 0.035). This difference in the success rate seems associated with the significantly higher amount of energy delivered in the 810 nm cohort (560 J) versus 1470 nm (186 J). Regardless of the type of laser, anatomical success was significantly higher after treatment with more than 400 J (66%) compared with 0-200 J (40%, p = 0.009) and 200-400 J (43%, p = 0.029). Complications were limited to two cases of transient paresthesia.
  
  
  CONCLUSIONS
  EVLA of IPVs is safe and feasible. The amount of energy is highly important in achieving anatomical success.
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, Den Bosch, The Netherlands doekeboersma@gmail.com.
authors.forename: Doeke
authors.initials: D
authors.lastname: Boersma
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, Den Bosch, The Netherlands.
authors.forename: Daan L J
authors.initials: DL
authors.lastname: Smulders
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, Den Bosch, The Netherlands.
authors.forename: Olaf J
authors.initials: OJ
authors.lastname: Bakker
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, Den Bosch, The Netherlands.
authors.forename: Ronald F F
authors.initials: RF
authors.lastname: van den Haak
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, Den Bosch, The Netherlands.
authors.forename: Bart A N
authors.initials: BA
authors.lastname: Verhoeven
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, Den Bosch, The Netherlands.
authors.forename: Olivier H J
authors.initials: OH
authors.lastname: Koning
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: EVLA; Perforator; varicose vein