Department of Vascular Surgery Sint-Andriesziekenhuis Krommewalstraat 118700 Tielt, Belgium.
Eur J Vasc Endovasc Surg. 2010 Jul;40(1):110-6. doi: 10.1016/j.ejvs.2009.09.013. Epub 2009 Oct 23.
In this histological study, the lateral saphenous vein of the goat was treated using a laser fibre to which a tulip-shaped, self-expandable catheter had been fixed to achieve endovenous laser ablation (EVLA). The catheter centres the laser fibre in the vein preventing direct contact with the vein wall. This study aims to establish whether prevention of direct contact between the fibre tip and the vein wall prevents ulceration and perforation of the vein wall and perivenous tissue destruction.
Ten lateral saphenous veins were treated, using the tulip catheter, in goats under general anaesthesia. Ten more veins were treated with a normal bare fibre. We used a 980 nm diode laser to provide the energy. Postoperatively the veins were removed immediately, at 10 days and after 3 weeks for histological examination. Destruction of the vessel wall was measured and perivenous tissue destruction was quantified using a graded scale.
Ulceration and perforation were prevented when using the tulip catheter. It also achieved more even vein wall necrosis. Tulip-catheter-treated veins show a transmural vein wall necrosis in, on average, 80% of the total circumference compared to 64% in bare-fibre treated veins. Less perivenous tissue destruction was seen with the new catheter (perivenous tissue destruction scale: tulip catheter: 1.7 vs. bare fibre: 3.8). Three weeks after treatment, we found regression of the perivenous tissue destruction as the healing process continued.
EVLA using the tulip catheter avoids ulceration and perforation of the vein associated with treatment using a bare fibre. It also results in more even circumferential vein wall necrosis and less perivenous tissue destruction.
在这项组织学研究中，使用固定有郁金香形状自膨式导管的激光光纤对山羊的外侧隐静脉进行处理，以实现静脉内激光消融（EVLA）。该导管将激光光纤置于静脉中心，防止其与静脉壁直接接触。本研究旨在确定光纤尖端与静脉壁之间是否存在直接接触，以防止静脉壁溃疡和穿孔以及静脉周围组织破坏。
在全身麻醉下，使用郁金香导管对 10 条外侧隐静脉进行处理，对另外 10 条静脉使用普通裸光纤进行处理。我们使用 980nm 二极管激光提供能量。术后立即、第 10 天和第 3 周取出静脉进行组织学检查。测量血管壁的破坏程度，并使用分级量表量化静脉周围组织的破坏程度。
使用郁金香导管可防止溃疡和穿孔。它还实现了更均匀的静脉壁坏死。与裸光纤处理的静脉相比，郁金香导管处理的静脉在平均 80%的总周长范围内表现出贯穿静脉壁的坏死，而裸光纤处理的静脉为 64%。新导管的静脉周围组织破坏程度较低（静脉周围组织破坏程度量表：郁金香导管为 1.7，裸光纤为 3.8）。治疗 3 周后，随着愈合过程的继续，我们发现静脉周围组织的破坏有所消退。
使用郁金香导管的 EVLA 可避免与裸光纤处理相关的静脉溃疡和穿孔。它还导致更均匀的环形静脉壁坏死和较少的静脉周围组织破坏。
