Huisman L C, Bruins R M G, van den Berg M, Hissink R J
Department of General Surgery, Scheper Ziekenhuis, Postbus 30002, 7800 RA Emmen, The Netherlands.
Eur J Vasc Endovasc Surg. 2009 Aug;38(2):199-202. doi: 10.1016/j.ejvs.2009.04.003.
To evaluate treatment of the small saphenous vein (SSV) by endovenous laser ablation.
A cohort study, occlusion of the vein and safety of the procedure was analysed prospectively.
150 consecutive patients (169 limbs) were treated between August 2006 and January 2008 in an outpatient clinic setting. The average age was 57 years (range 23-87); 82% female; 31% had serious varicose disease (CEAP 3-6). Treated length averaged 23 cm (range 6-53 cm).
All patients underwent a standardised assessment comprising digital questionnaire, physical examination and duplex ultrasonography. The SSV was cannulated percutaneously under ultrasound control and perivascular local anaesthesia (tumescent) was injected. An 810 nm diode laser was used, delivering 70 J/cm. Three months post-treatment all patients received a duplex ultrasound of the treated vessel.
Complete occlusion of the SSV after 3 months was achieved in 98% of the cases. Two patients (1.3%) had sural nerve paraesthesia. Six patients developed superficial thrombophlebitis. Serious complications did not occur.
Endovenous laser ablation for treating the incompetent small saphenous vein is a safe, effective and technically feasible technique.
评估静脉腔内激光消融治疗小隐静脉（SSV）的效果。
一项队列研究，前瞻性分析静脉闭塞情况及该手术的安全性。
2006年8月至2008年1月期间，在门诊环境中对150例连续患者（169条肢体）进行了治疗。平均年龄为57岁（范围23 - 87岁）；82%为女性；31%患有严重静脉曲张疾病（CEAP 3 - 6级）。治疗长度平均为23 cm（范围6 - 53 cm）。
所有患者均接受了包括数字问卷调查、体格检查和双功超声检查在内的标准化评估。在超声引导下经皮穿刺小隐静脉，并注射血管周围局部麻醉剂（肿胀麻醉）。使用810 nm二极管激光，能量为70 J/cm。治疗后3个月，所有患者均接受了治疗血管的双功超声检查。
98%的病例在3个月后实现了小隐静脉完全闭塞。2例患者（1.3%）出现腓肠神经感觉异常。6例患者发生浅表血栓性静脉炎。未发生严重并发症。
静脉腔内激光消融治疗功能不全的小隐静脉是一种安全、有效且技术上可行的技术。
