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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2013 June;20(2):105-9
Does tumescent solution delivery displace the fiber position in endovenous laser ablation procedure?
Altin F. H., Kutas B., Gunes T., Aydin S., Eygi B., Sevuk U., Erkoc K. ✉
Department of Cardiovascular Surgery, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
Aim: This study evaluated the direction and the distance of the laser fiber migration after tumescent solution delivery in patients with primary varicose veins due to great saphenous vein (GSV) reflux who were treated with 1470 nm diode laser and 600 µm core radial fiber through a prospective nonrandomized study.
Methods: From December 15, 2011 to May 10, 2012; 36 endovenous laser ablation procedures were performed in 30 patients. The distances from the fiber tip to superficial epigastric vein (SEV) and to saphenofemoral junction (SFJ) were measured with ultrasound before and after tumescent solution delivery.
Results: After placing the laser fiber, the distances from SFJ and SEV to fiber tip were respectively 2.02±0.21 cm and 2.10±0.29 cm. After tumescent solution, the distances from SFJ and SEV to fiber tip were respectively 2.25±0.35 cm and 2.30±0.39 cm. In 33 limbs (91.6 %) fiber tip was moved towards the distal side, and in 3 limbs (8.3 %) it was moved towards the proximal side . In proximally migrated 3 limbs, according to the measurements from fiber tip to SFJ, distance of migration were detected as 0.7; 0.6 and 0.3 cm. In the same patients, according to the measurements from fiber tip to SEV, the distance of migration were detected as 0.6; 0.6 and 0.3 cm.
Conclusion: The shift direction of the laser fiber is found to be towards the distal side of the GSV. Considering the maximum shift distances, if the laser fiber is placed 2 cm distally from SFJ or SEV before tumescent solution delivery, the migration of the laser fiber doesn’t cause any complication.