Endovenous laser treatment: is there a clinical difference between using a 1500 nm and a 980 nm diode laser? A multicenter randomised clinical trial.

AIM

We compared the use of two different laser wavelengths in the treatment of great saphenous vein (GSV) reflux: the 1500 nm versus the 980 nm diode laser. We studied the occlusion rates and noted possible side-effects.

METHODS

In three centers 180 great saphenous veins were treated with endovenous laser ablation (EVLA). By random selection half of the patients were treated with a 980 nm laser and half with a 1500 nm laser. A Duplex scan was scheduled at one month and six months postoperatively. Ecchymosis was measured at one week using a calculated scale. In addition the need for analgesics, the induration around the treated vein and patient satisfaction rate were noted. At two weeks postoperatively a quality of life score (CIVIQ2) was obtained.

RESULTS

The complete occlusion rates at six months were not statistical significant different between both groups (95.5% for 980 nm and 93.1% for 1500 nm). Most of the non-occluded veins had a filiform internal lumen and did not show reflux. There was no significant difference in the postoperative appearance of ecchymosis (P=0.09). Patients treated with a 1500 laser had less induration around the treated vein (P=0.002), less need to take analgetics (1.8 days versus 2.9 days) and had a better postoperative quality of life (P=0.018). The patient satisfaction rate did not differ in the two groups.

CONCLUSION

Using a 1500 nm diode laser in the treatment of an incompetent GSV, compared to the use of a 980 nm laser, results in similar occlusion rates at six months, but somewhat less side-effects.