title: Retrograde Endovenous Laser Ablation through Saphenopopliteal Junctional Area for Incompetent Small Saphenous Vein: Comparison with Antegrade Approach.
abstract: To evaluate the safety and efficacy of retrograde endovenous laser ablation (EVLA) and to compare it with the conventional antegrade EVLA for incompetent small saphenous vein (SSV).
  
  
  
  Small saphenous vein was cannulated via two approaches under ultrasound-guidance. One method involved puncturing the SSV cranially at mid-calf (the antegrade group). If the antegrade puncture into the SSV failed twice, the other approach for puncture was selected that involved puncturing the SSV toward the ankle (the retrograde group). Patients were evaluated in terms of technical & clinical success, closure rates of the SSV, and complications including pain, bruising, or paresthesia at all follow-up visits.
  
  
  
  The 1470 nm endovenous laser was used in all limbs. Technical success was seen in all limbs in both groups (100%). Closure rate in both groups showed about 95%, without significant difference (p = 0.685). Similar linear endovenous energy density was supplied during the EVLA in both groups (p = 0.876). Three frequent complications including bruising, pain, and paresthesia did not show statistical significance between groups (p = 0.465, 0.823, 1.000, respectively). Major complications were absent in both groups.
  
  
  
  The EVLA for the incompetent SSV using a retrograde approach is safe and effective and should be considered the alternative method if the antegrade access fails due to vasospasm or small SSV diameter.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Jun Seok
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Ik Jin
authors.initials: IJ
authors.lastname: Yun
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Jae Joon
authors.initials: JJ
authors.lastname: Hwang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Song Am
authors.initials: SA
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Hyun Keun
authors.initials: HK
authors.lastname: Chee
authors.affiliation: Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Hwang
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D053685:Laser Therapy / Q000379:methods*; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography; D014689:Venous Insufficiency / Q000401:mortality / Q000601:surgery*
keywords: Lasers; Ultrasound; Veins