Endovenous laser treatment for primary varicose veins

Venous insufficiency of the lower extremities is a highly prevalent condition. Successful treatment of superficial venous insufficiency will most often necessitate treatment of the saphenofemoral junction incompetence with correction of saphenous vein reflux. In the majority of patients it concerns a reflux of the greater saphenous vein. The standard procedure consists of ligation and stripping of the greater saphenous vein combined with with additional phlebec-tomies or ligation of insufficient perforant veins if necessary. Although the standard procedure is widely known and accepted, the postoperative morbidity and postoperative limitations of activity are high. In this context minimally invasive percutaneous endovenous techniques were developed to improve the patients comfort and faster resumption of work. Among these, endovenous laser ablation of the greater saphenous vein is a relatively new procedure. Percutaneous introduction of a laser fiber into the incompetent vein and ablation with pulsed laser energy is far less invasive than stripping.     

腔内钬激光治疗下肢静脉曲张

目的探讨腔内钬激光治疗下肢静脉曲张的操作要点、技术优势、临床效果及作用机理。方法对96例下肢静脉曲张患者(99条肢体)采用600μm钬激光光纤,通过介入方法进行腔内钬激光大隐静脉闭合术。患者术前、中、后进行多普勒超声检查。记录手术时间;观察临床效果及并发症。平均随访时间7个月。结果67条(68％)大隐静脉在术中即刻闭合,术后1周内99条大隐静脉全部闭塞。随访期内多普勒超声检查无血管再通现象。无创口感染。2例患者有轻度皮肤灼伤。1例患者隐神经损伤。3例患者有大腿瘀斑。结论腔内钬激光治疗下肢静脉曲张的临床初步结果满意,具有美观、简便、微创的特点。     

Endovenous laser treatment for primary varicose veins

Venous insufficiency of the lower extremities is a highly prevalent condition. Successful treatment of superficial venous insufficiency will most often necessitate treatment of the saphenofemoral junction incompetence with correction of saphenous vein reflux. In the majority of patients it concerns a reflux of the greater saphenous vein. The standard procedure consists of ligation and stripping of the greater saphenous vein combined with with additional phlebectomies or ligation of insufficient perforant veins if necessary. Although the standard procedure is widely known and accepted, the postoperative morbidity and postoperative limitations of activity are high. In this context minimally invasive percutaneous endovenous techniques were developed to improve the patients comfort and faster resumption of work. Among these, endovenous laser ablation of the greater saphenous vein is a relatively new procedure. Percutaneous introduction of a laser fiber into the incompetent vein and ablation with pulsed laser energy is far less invasive than stripping.     

Endovenous laser treatment of varicose veins

Endovenous laser treatment (EVLT) has become a standard therapy for the treatment of superficial venous insufficiency. It offers a rapid, office-based therapy with minimal patient downtime and an easier recovery than traditional surgical treatment. EVLT is effective and durable and can successfully treat saphenous truncal insufficiency and accessory branches with low complication rates. EVLT can increase patient satisfaction and enable the treatment of a wider variety of patients with a more efficient procedure compared with traditional techniques.     

静脉腔内激光治疗下肢静脉曲张的疗效观察

目的　评价静脉腔内激光治疗下肢静脉曲张的疗效。方法　 46例患者共 5 4条患肢行单纯激光治疗或大隐静脉高位结扎加激光治疗。结果　所有患者的静脉曲张均闭塞。 19.5 %患者出现肢体淤斑 ,81.5 %患者肢体发生沿大隐静脉行程条索状硬结或硬块 ,11.1%患者皮肤局部麻木 ,1例患者发生皮肤浅表烧伤。所有患者均获随访 ,平均随访 6个月 (3～ 8个月 ) ,均痊愈。无深静脉血栓 ,无局部复发 ,疗效满意。结论　静脉腔内激光治疗是一种安全、有效、微创的治疗方法 ,选择大隐静脉高位结扎加激光治疗则更安全。     

剥脱联合腔内激光治疗大隐静脉曲张

目的:探讨剥脱术联合腔内激光治疗大隐静脉曲张的疗效.方法:回顾性分析2006年4月-2009年3月采用大隐静脉的大腿段剥脱联合小腿段激光腔内治疗的128例患者(176条肢体)的临床资料.结果:全组患者手术效果满意,症状缓解率100％,无伤口感染、下肢深静脉血栓形成等.近期并发症为胫前皮下淤血或小血肿12肢(6.8％),皮肤条状烧伤2肢(1.1％),浅静脉周围炎12肢(6.8％),踝部水肿2肢(1.1％);无胫前麻木感,无远期严重并发症;3年内无静脉曲张复发.结论:剥脱术联合腔内激光治疗大隐静脉曲张疗效确切,并发症少,是安全可靠的微创治疗方法.     

腔内激光治疗下肢原发性静脉曲张62例

目的总结原发性下肢静脉曲张患者行腔内激光治疗的经验和效果。方法62例下肢原发性静脉曲张患者均采用二极管激光仪行腔内激光治疗。激光治疗功率为10～12W,激光脉冲持续时间为1s,间隔时间为1s,逐渐退出静脉腔。结果随访时间为2～8个月。全部患者的曲张静脉消失,水肿消退,无坠胀感,无搔痒,无需用吗啡类镇痛药,无严重并发症。结论腔内激光治疗下肢原发性静脉曲张安全,效果满意。     

腔内激光治疗大隐静脉曲张192例报告

目的 探讨腔内激光治疗大隐静脉曲张的疗效。方法 2004年7月～2006年3月我院对192例238条肢体大隐静脉曲张行高位结扎、激光烧灼静脉主干和小腿曲张静脉。小腿局部严重曲张的静脉团,另做切口做局部切除或点状抽拨。结果 本组一次治愈率96.2%（229/238）。9例9条肢体术后因仍有少量曲张静脉存在,局麻下行切除或再次激光治愈。114例大隐静脉主干及小腿局部条索状硬结、疼痛;9例皮肤灼伤。术后住院时间4～8 d,平均5.6 d。158例随访1～18个月,平均11.6月,未见复发。结论 腔内激光治疗大隐静脉曲张效果确切,创伤小。     

Endovenous radiofrequency ablation for the treatment of varicose veins

Chronic venous insufficiency (CVI) is the most common vascular disease and represents a significant health care problem in the United States. Reflux of the great saphenous vein is the most common cause of this condition, whose symptoms include varicose veins, leg swelling, skin discoloration, and ulceration. The traditional treatment of this condition is saphenofemoral ligation with stripping of the saphenous vein followed by varicose vein removal, if necessary. Recent advances in minimally invasive endovenous therapy have led to the development of catheter-based radiofrequency ablation (RFA) of the saphenous vein, which has gained an increasing acceptance in clinical practice. Endovenous RFA was introduced into clinical practice in Europe in 1998 and in the United States in 1999. Since then, over 250,000 procedures have been performed worldwide. Procedure safety and efficacy are well understood, with over 60 publications on the subject in the peer review literature, including four randomized trials comparing this technology with traditional vein stripping surgery. With the advent of tumescent anesthesia, the majority of RFA procedures are now performed in an office setting. This article examines the current technology using RFA in saphenous vein ablation with the Closure catheter system. Procedural techniques and clinical outcome using RFA in saphenous vein ablation are discussed. Clinical data comparing RFA versus saphenous vein stripping are also examined. Lastly, the clinical utility of a new RFA catheter, ClosureFAST, is discussed. ClosureFAST is a new generation of RFA catheter and has exhibited significant improvement in the ease of use and the procedure speed over the previous generation catheters while maintaining the favorable patient recovery profile seen with the RFA technology.     

激光对静脉曲张作用机制的研究

目的 初步探讨半导体激光治疗下肢静脉曲张的作用机制.方法 不同试验条件下观察和比较激光对静脉壁的生物学效应,进行病理学检验;检测静脉腔内激光治疗后患者在1、3、5、7d血凝状态变化.结果 静脉腔内半导体激光治疗后静脉壁全程均可见明显碳化,局部有全层穿孔,内膜剥脱破坏,细胞轮廓丧失,纤维蛋白沉积,许多区域呈现明显的空泡和...     

Endovenous laser therapy and radiofrequency ablation of saphenous varicose veins

Radiofrequency ablation (RFA) and endovenous laser treatment (EVLT) are minimal invasive methods to treat saphenous varicose veins. The short- and mid-term results are excellent with an occlusion rate for RFA of almost 90% after 5 years and about 95% for EVLT after 2 years. Severe side effects are rare in both cases. Prospective randomised comparative studies are available for RFA and surgery showing comparable short-term results and superiority of RFA concerning short-term quality of life outcome. For laser treatment no prospective randomised comparative studies are available. Endovenous treatment is only a part of the complex treatment concept of varicose veins. Insufficient tributaries have to be treated in addition. The fact that the insufficient saphenous vein is treated without high ligation seems not to influence the short-term and mid-term recurrence rates. More prospective randomised comparative studies comparing endovenous treatment and surgery or foam sclerotherapy are necessary to decide which method is the best for which patient.     

Endovenous laser ablation of saphenous vein is an effective treatment modality for lower extremity varicose veins

We present our first experiences with the use of a new minimally invasive treatment of lower extremity varicose veins. We studied the occlusion rates of the great saphenous vein (GSV) with laser ablation, its failure rates, and its complications. Sixty-six limbs in 62 consecutive patients were treated and followed-up for 1 year. All of the patients had incompetent GSV proven by means of duplex scanning. The GSV segment from 2 cm distal to the sapheno-femoral junction to just above the knee was ablated by using laser energy. In addition, all patients had stab avulsions of the varicose veins of the leg with Crochet hooks. All patients were followed postoperatively on the 3rd day, 1 month, 3 months, and 1 year after surgery. All patients were treated as day-case surgeries. Among 62 patients studied, 46 patients were women (74%) and 16 were men (26%). The median age of the patients was 53 years (range 28-69 years). Median operation time was 65 min (range 40-140 min). Successful treatment (total obliteration of the GSV on duplex) was accomplished in 64 of 66 limbs (97%). In two cases, recanalization of the lower one-third of the treated segment of the GSV was noted after 3 months. There were no instances of neuropathy or skin burn. Endovenous laser ablation of varicose veins is effective in inducing thrombotic vessel occlusion and is associated with only minor adverse effects. The procedure seems to be a promising alternative for surgical stripping of the GSV.     

腔内激光治疗下肢静脉曲张:附170例报告

目的　评价腔内激光治疗静脉曲张的效果。方法　对 170例下肢静脉曲张患者采用810nm激光仪进行治疗。治疗后绷带加压包扎 2d后改穿弹力袜 6～ 8周。随访期间用多普勒检查。结果　全组无并发症。 170例术后随访 1～ 12个月 ,所有大隐静脉均闭塞 ,无并发症 ;所有症状改善或消失。其中 80例随访 1年 ,大隐静脉无再通 ,无复发。结论　腔内激光治疗静脉曲张的效果满意。该微创治疗技术显示安全 ,具有良好的大隐静脉闭塞作用     

腔内激光微创治疗下肢静脉曲张450例报告

目的 总结静脉腔内激光治疗（endovenous laser treatment,EVLT）下肢静脉曲张的疗效和术后并发症。方法 2003年10月～2006年2月,对450例（606条肢体）下肢静脉曲张采用发射功率为15～22 W的940 nm激光连续发射模式治疗,术后定期彩超随访疗效。结果 随访2～29个月,平均16个月。448例疗效满意,曲张静脉消失,下肢酸胀沉重感觉明显改善。术前下肢伴有活动性溃疡49例中,44例手术后10天内愈合,5例术后16天愈合。5例皮肤灼伤患者7天出院。彩超复查5条（0.8%）患肢静脉部分再通,再次穿刺激光治疗。结论 EVLT是治疗下肢静脉曲张的全新微创手术,安全有效,操作简单,适合传统手术治疗者均可采用,尤其适合静脉曲张较轻患者。     

腔内激光联合Trivex 旋切术治疗重度下肢浅静脉曲张的临床效果

目的：探讨腔内激光治疗术联合Trivex旋切术治疗重度下肢浅静脉曲张的临床疗效。 方法：分析2012年7月—2013年10月收治的20例（26条肢体）重度下肢原发性下肢静脉曲张患者临床资料。患者均行腔内激光治疗术联合Trivex旋切术治疗。 结果：全部患者顺利完成手术。术后下肢静脉曲张均消失,色素沉着、瘙痒、湿疹、皮肤溃疡等并发症不同程度的减轻;并发皮下淤斑、局部肿胀4例,均在1个月内消失;1例出现患肢小腿外侧肿胀,穿刺抽吸积液并以弹力绷带加压包扎后肿胀消退;2例出现患肢皮肤麻木,2个月后消失;2例大隐静脉主干部位和曲张静脉烧灼处出现条索状硬结,并伴有局部轻中度疼痛,2~3周症状逐渐消失。术后平均随访8个月,无曲张静脉复发及小腿无明显瘢痕。 结论：腔内激光治疗术联合Trivex旋切术对原发性下肢静脉曲张具有良好的治疗效果治疗,且具有微创及美容效果好等优点。     

Endovenous laser ablation of varicose veins: review of current technologies and clinical outcome

Symptomatic lower extremity varicose veins represent one of the most common vascular conditions in the adult population. Associated symptoms ranged from mild conditions such as fatigue, heaviness, and itching to more serious conditions such as skin discoloration and leg ulceration. The predominant causative factor of this condition is reflux of the great saphenous vein (GSV), which is traditionally treated with surgical saphenofemoral ligation and stripping of the incompetent saphenous vein. In recent years, there have been significant advances in saphenous vein ablation using percutaneous techniques, including the endovenous laser therapy (EVLT). In this article, the authors discuss the therapeutic evolution of this technology, theoretical basis of laser energy in GSV ablation, and procedural techniques of EVLT using duplex ultrasonography. Additional discussion of procedural-related complications, such as deep vein thrombosis, skin burn, saphenous nerve injury, and phletibis, and ecchymosis, are provided. Lastly, clinical results of EVLT in GSV ablation are discussed. Current literatures support EVLT as a safe and effective treatment option for varicosities caused by GSV incompetence.     

Systematic review of endovenous laser treatment for varicose veins

BACKGROUND: The safety and effectiveness of endovenous laser treatment (EVLT) for varicose veins are not yet fully evaluated. METHODS: Medical bibliographic databases, the internet and reference lists were searched from January 1966 to September 2004. Only case series were available for inclusion in the review. RESULTS:: Thirteen studies met the inclusion criteria. Self-limiting features, such as pain, ecchymosis, induration and phlebitis, were commonly encountered after treatment. Deep vein thrombosis and incorrect placement of the laser in vessels were uncommon adverse events. No study has yet assessed the effectiveness of laser therapy in comparison to saphenofemoral junction ligation with saphenous vein stripping. Occlusion of the saphenous vein and abolition of venous reflux occurred in 87.9-100 per cent of limbs, with low rates of re-treatment and recanalization. CONCLUSION: From the low-level evidence available it seems that EVLT benefits most patients in the short term, but rates of recanalization, re-treatment, occlusion and reflux may alter with longer follow-up. The lack of such data, in addition to the small numbers of patients in the available studies, demonstrates the need for a randomized clinical trial of EVLT versus conventional surgery.