ABSTRACT

To present the immediate and short-term results of our first 60 endovenous laser (EVL) ablation procedures.

Between July 2005 and December 2006, 60 EVL ablations were performed in 36 symptomatic patients (26 females, 10 males; mean age ± SD, 46 ± 14 years). The incompetent veins included the great saphenous vein (GSV) (n = 52), small saphenous vein (n = 6), and major branches of the GSV (n = 2). In all cases incompetent veins were punctured under ultrasound (US) guidance and the laser fiber was placed into these veins through a vascular sheath or with the help of a catheter. After tumescent anesthesia was administered, the veins were ablated with laser by delivering 50–100 joules/cm energy to the vein wall. Following EVL ablations, 29 patients also underwent foam sclerotherapy to treat the remaining varicosities. After the EVL ablation ± sclerotherapy, patients were followed- up with Doppler US at 1 week, and then 3, 6, and 12 months post procedure.

In all patients EVL ablation was technically successful. Complications were minor and included transient visual disturbance due to foam sclerotherapy (n = 1), bruising/ ecchymoses (n = 24), postoperative pain (n = 16), and superficial thrombophlebitis (n = 6). All patients returned to normal activity within 2 days. During the 7 ± 5 months (mean ± SD) of follow-up, recurrent reflux was seen in only one patient, in both GSVs, which was successfully treated with foam sclerotherapy.

EVL ablation is a safe and effective method for the management of saphenous vein insufficiency.

Keywords: varicose veins • catheter ablation • laser coagulation • endovenous laser ablation