Endovenous Laser Ablation of Varicose Veins after Direct Percutaneous Puncture: Early Results

BACKGROUND: Although endovenous laser ablation has been demonstrated to effectively occlude incompetent saphenous veins, it does not treat branch varicosities directly. OBJECTIVE: The objective was to evaluate the technical feasibility and early results of the direct ablation of branch varicosities using a 980-nm diode laser. MATERIALS AND METHODS: From July to August 2005, 17 patients (21 limbs; male:female ratio, 7:10; mean age, 50.1 years; range, 24-62 years) with varicose veins were enrolled in this study. Endovenous laser ablation was performed in incompetent saphenous veins. Thereafter, branch varicosities were percutaneously punctured and a direct laser ablation was performed using a 400-microm laser fiber. Patients were evaluated at 1 week and at 1-, 3-, and 6-month intervals. RESULTS: Technical success in branch varicosities was achieved in 11 of 15 limbs (71.4%). Continued closure of treated saphenous veins was evident in 11 of 11 limbs (100%) at 1-month follow-up. Successful ablation in varicose tributaries was seen in 6 of 11 limbs (54.5%) at 1-month follow-up and ablation failed in 5 limbs. One of the 11 limbs (9%) had a skin burn that required treatment. CONCLUSION: Despite partly successful occlusion, we suggest that direct laser ablation cannot replace classic methods of treating branch varicosities, because of its high failure rate and the risk of skin burns.