Evaluation of great saphenous vein occlusion rate and clinical outcome in patients undergoing laser thermal ablation with a 1470-nm bare fiber laser with low linear endovenous energy density

Avaliação da taxa de obliteração da veia safena magna e da evolução clínica de pacientes submetidos a termoablação com laser 1470 nm, fibra linear e baixa densidade de energia endovenosa linear

Background  Water-specific 1470-nm lasers enable vein ablation at lower energy densities and with fewer side effects because they target interstitial water in the vessel wall.

Objectives  To determine great saphenous vein (GSV) occlusion rate after thermal ablation with 1470-nm laser using 7W power and to evaluate clinical outcomes and complications.

Method  Nineteen patients (31 GSVs) underwent thermal ablation. Follow-up duplex scanning, clinical evaluation using the Venous Clinical Severity Score (VCSS), and evaluation of procedure-related complications were performed at 3-5 days after the procedure and at 30 and 180 days.

Results  Mean patient age was 46 years and 17 of the patients were female (89.47%). Of 31 limbs treated, 2 limbs were clinical class C2, 19 were C3, 9 were C4, and 1 limb was C5 according to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. Mean linear endovenous energy density was 33.53 J/cm. The GSV occlusion rate was 93.5% immediately after treatment, 100% at 3-5 days and 100% at 30 days after treatment and 87.1% 180 days after treatment. There was a significant reduction in VCSS at all time points.

Conclusions  The data from this study support the possibility that the incidence of complications can be reduced without significantly affecting the clinical outcomes, by using lower energy density. However, this appears to be at the cost of reduced efficacy in terms of GSV occlusion rates.

Keywords:
ablation techniques; laser therapy; varicose veins