Petronelli S, Prudenzano R, Mariano L, Violante F
UOS di Angiografia e Radiologia Interventistica, Ente Ecclesiastico, Ospedale Regionale "Miulli", Via Maselli Campagna, 1-70021 Acquaviva delle Fonti, Bari, Italy.
Radiol Med. 2006 Feb;111(1):85-92. doi: 10.1007/s11547-006-0009-4.
The aim of this study was the development of a new, even less invasive technique, for the treatment of varicose veins of the lower limbs than traditional surgery (ligation with stripping of the saphenous vein).
The new interventional radiological procedure uses the 810- to 980-nm endovascular laser fibre proposed by Min et al. Our technique involves the superselective catheterisation of the great saphenous vein under fluoroscopy with contralateral venous access achieved by performing iliac crossover. Retrograde and anterograde phlebographies are performed with a needle cannula positioned in the dorsum of the foot. This enables accurate venous mapping during the procedure of laser photothermolysis. We treated 52 patients between June 2003 and June 2004, with a percentage of recanalisation of 7.5% at 1 year.
The contralateral approach allows greater control over the entire procedure, with a reduction in potential risks in relation to the saphenofemoral junction given that, unlike in the technique proposed by Min et al. the tip of the laser is directed at all times towards the saphenous vein and never towards the femoral vein. This more radical procedure offers a significant reduction in the possibility of relapse of varicose disease of the saphenofemoral junction.
本研究的目的是开发一种新的、侵入性更小的技术，用于治疗下肢静脉曲张，该技术比传统手术（大隐静脉结扎剥脱术）侵入性更小。
新的介入放射学程序使用Min等人提出的810至980纳米的血管内激光光纤。我们的技术包括在透视下对大隐静脉进行超选择性插管，通过髂静脉交叉实现对侧静脉通路。使用置于足背的针套管进行逆行和顺行静脉造影。这使得在激光光热消融过程中能够进行精确的静脉造影。我们在2003年6月至2004年6月期间治疗了52例患者，1年时再通率为7.5%。
对侧入路可更好地控制整个手术过程，与隐股交界处相关的潜在风险降低，因为与Min等人提出的技术不同，激光尖端始终指向大隐静脉，而从不指向股静脉。这种更彻底的手术方法显著降低了隐股交界处静脉曲张疾病复发的可能性。
