ORIGINAL ARTICLES   

International Angiology 2009 February;28(1):32-7

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Does laser power influence the results of endovenous laser ablation (EVLA) of incompetent saphenous veins with the 1 470-nm diode laser? A prospective randomized study comparing 15 and 25 W

Maurins U. ¹, Rabe E. ², Pannier F. ³

¹ Center of Phlebology, Health Center 4, Riga, Latvia 2 Department of Dermatology, University of Bonn, Germany 3 Dermatologie Kastanienhof, Köln, Germany

Aim. Major side effects after endovenous laser ablation (EVLA) are pain and bruising. The aim of this study was to compare outcome and side effects after EVLA of incompetent great saphenous veins (GSV) with a 1 470 nm diode laser (Ceralas E, biolitec) using a power of 15 or 25 W.
Methods. Between 28 November 2007 and 15 January 2008, 40 consecutive patients (40 legs) with an incompetent GSV were treated by EVLA. The patients were randomized in two groups. In Group A (20 patients) was used a 15-W-power laser and in Group B (20 patients) a 25-W-power laser was used. All patients were re-examined after 1, 10 and 30 days clinically and by Duplex for complications and occlusion in the treated vein segment in a standardized way.
Results. There was no significant difference concerning gender, age, C of CEAP, body mass index or diameter of the treated vein. In Group A a mean of 465 mL tumescence fluid (TF) was used and in Group B TF was of 433 mL. In Group A the mean linear endovenous energy density (LEED) was 109.7 J/cm and in Group B 132.6 J/cm. The subgroup Bsub included 16 patients of Group B with a comparable mean LEED of 115.8 J/cm. In all groups occlusion of the treated veins was achieved for all patients. The diameter of the GSV reduced at 3 cm below the sapheno-femoral junction from 1.1 to 0.6 cm, 1.0 to 0.6 cm and 0.9 to 0.6 cm respectively in the three groups. The modified CEAP clinical score improved significantly in all groups. In Group A patients have been administered analgesic tablets for a shorter period. There was also a trend to less postinterventional pain and analgesic use in Group A, but it was not significant. Ecchymosis was rare in both groups (8 in Group A, 7 in Group B).
Conclusion. In this prospective randomized comparative study the power of the laser did not influence the occlusion rate when a high LEED with comparable values was used. In both groups pain and ecchymoses were less frequent in this study with a 1 470 nm diode laser than reported in studies with 810-980 nm systems. A lower power level significantly reduced use of analgesic tablets.