Department of Radiodiagnosis, Government Medical College & Hospital, Nagpur, Maharashtra 440003, India.
J Vasc Interv Radiol. 2010 Dec;21(12):1835-40. doi: 10.1016/j.jvir.2010.09.009. Epub 2010 Nov 3.
The aim of this study was to evaluate safety and effectiveness of the laser fiber with wavelength of 1470 nm for ablation of symptomatic varicose veins.
This was a prospective study carried out from November 2007 to October 2009. Seventy-six limbs in 72 consecutive patients were treated by endovenous laser ablation (EVLA). Baseline preprocedural clinical and ultrasonic grading of varicose veins was done. Endovenous laser ablation was done under ultrasonic guidance, and prior superficial venogram was taken if required. After the procedure all the patients were followed up with for 1 year with duplex ultrasound scan, and improvement in grading of venous disease was assessed.
One hundred eight treated veins of 76 limbs were followed up on day 2, 1 month, 6 month, and 12 months postprocedurally. At the end of 1-year follow-up, venous occlusion rate and ulcer healing rate were 98.61% and 85%, respectively. The average preoprocedure clinical grade and venous disability score improved significantly at 12 months. Most of the postprocedure complications were transient and self limiting; the most common complication was paresthesia (10.53%). No major complications, such as deep vein thrombosis, occurred. When the authors compared legs treated with linear endovenous energy density below or above 100 J/cm, the paresthesia rate and postoperative pain was significantly higher in the second group, with energy density more than 100 J/cm.
EVLA, using 1470-nm laser, is a minimally invasive, safe, outpatient department (OPD) procedure that causes less postprocedural pain with linear endovenous energy density (LEED) less than 100J/cm.
本研究旨在评估 1470nm 激光光纤消融治疗症状性静脉曲张的安全性和有效性。
这是一项前瞻性研究，于 2007 年 11 月至 2009 年 10 月进行。72 例连续患者的 76 条肢体接受了静脉内激光消融术（EVLA）治疗。对静脉曲张的临床和超声分级进行了基线术前评估。在超声引导下进行静脉内激光消融术，如果需要，先进行浅表静脉造影。术后所有患者均进行为期 1 年的随访，采用双功能超声扫描，评估静脉疾病分级的改善情况。
76 条肢体的 108 条治疗静脉在术后第 2 天、1 个月、6 个月和 12 个月进行了随访。在 1 年随访结束时，静脉闭塞率和溃疡愈合率分别为 98.61%和 85%。术前临床分级和静脉残疾评分在 12 个月时显著改善。大多数术后并发症是短暂和自限性的；最常见的并发症是感觉异常（10.53%）。未发生深静脉血栓等重大并发症。当作者比较线性静脉能量密度低于或高于 100J/cm 的肢体时，能量密度超过 100J/cm 的第二组感觉异常率和术后疼痛明显更高。
EVLA 使用 1470nm 激光，是一种微创、安全的门诊手术，线性静脉能量密度（LEED）低于 100J/cm 时引起的术后疼痛较轻。
