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Rivista di Angiologia
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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International Angiology 2016 December;35(6):599-604
Endovenous laser ablation of the great saphenous vein comparing 1920-nm and 1470-nm diode laser
Daniel MENDES-PINTO 1, Paulo BASTIANETTO 1, Lívia CAVALCANTI BRAGA LYRA 1, Rodrigo KIKUCHI 2, Lowell KABNICK 3 ✉
1 Department of Vascular Surgery, Children ABC Hospital, Mater Dei Hospital and Vascular BH Institute, Belo Horizonte, Brazil; 2 Vascular Excellence Clinic, São Paulo, Brazil; 3 Division of Vascular and Endovascular Surgery, Langone Medical Center, New York University, New York, NY, USA
BACKGROUND: The aim of this study was to compare venous occlusion rates at a one-year follow-up comparing 1920-nm versus 1470-nm endolaser.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.