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Online ISSN 1827-1847
CONTROVERSIES IN VENOUS DISEASES
Mowatt-Larssen E., Shortell C.
Section of Vascular Surgery, Duke University Department of Surgery, Durham, NC, USA
Endovenous laser ablation at wavelengths between 810 nm and 1 470 nm is effective at ablating pathologic saphenous veins. Serious complications, such as clot extension into deep veins and permanent nerve injury, are rare, occurring in less than 1% of patients. Side effects, such as postoperative pain and bruising, however, remain common, although usually mild in intensity. Several innovations have been proposed to decrease these side effects. Higher laser wavelength lasers target water preferentially to hemoglobin. Fiber tips can be designed to fire radially at 360 degrees instead of linearly. Although theoretically appealing, these ideas still need to be tested against currently used options such as 810-980 nm bare tip lasers or radiofrequency devices in randomized, controlled trials. Proper energy dosing and tumescent anesthesia are currently more important keys to success than laser wavelength or radial firing.