Endovenous laser ablation of the great saphenous vein comparing 1920-nm and 1470-nm diode laser

• Published in: International angiology Vol. 35; no. 6; p. 599
• Main Authors: Mendes-Pinto, Daniel, Bastianetto, Paulo, Cavalcanti Braga Lyra, Lívia, Kikuchi, Rodrigo, Kabnick, Lowell
• Format: Journal Article
• Language: English
• Published: Italy 01-12-2016
• Subjects: Adult; Aged; Brazil; Female; Humans; Laser Therapy - adverse effects; Laser Therapy - instrumentation; Lasers, Semiconductor; Male; Middle Aged; Postoperative Complications - etiology; Prospective Studies; Saphenous Vein - physiopathology; Saphenous Vein - surgery; Severity of Illness Index; Time Factors; Treatment Outcome; Varicose Veins - diagnosis; Varicose Veins - physiopathology; Varicose Veins - surgery; Young Adult
• ISSN: 1827-1839

The aim of this study was to compare venous occlusion rates at a one-year follow-up comparing 1920-nm versus 1470-nm endolaser.
Randomized prospective study with consecutive patients with varicose veins associated to great saphenous reflux. The 1470-nm laser ablation was performed in continuous mode, with power of 10 W, while for the 1920-nm it was set in 5 W. Follow-up data were collected at the 7-day, 30-day, 3-month, 6-month and 1-year visits, and involved clinical, ultrasound evaluation and measurement of occlusion length.
Sixty seven patients were included, with 42 limbs operated in the 1470-nm group and 48 limbs in the 1920-nm group. There were no differences in relation to age, CEAP (Clinical, Etiologic, Anatomical and Pathological Classification), VCSS (Venous Clinical Severity Score) and saphenous diameter. The resulting LEED in 1920-nm group was 17.8±0.6 J/cm and vs. 24.7±0.8 J/cm in 1470-nm group (P<0.01). Closure rates were lower for the 1920-nm group: 90.9% vs. 96.8% (P=0.06) at 30 days, 87.5% vs. 96.3% at 6 months (P=0.03), and 87.5% vs. 94.7% (P=0.05) at one year. The 1920-nm group had less ecchymosis (18.7% vs. 52.4%), induration (12.4% vs. 38.1%) and days of analgesic use (1.4±0.2 vs. 2.4±0.4). CEAP and VCSS were reduced over time in both groups.
Treatment with endolaser 1920-nm was feasible and with reduced complications. The use of low endoluminal energy resulted in lower vein occlusion rates comparing to the 1470-nn laser. Clinical outcome scores were similar between groups.