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静脉内激光消融的来龙去脉:反思

Ins and outs of endovenous laser ablation: afterthoughts.

作者信息

Neumann H A Martino, van Gemert Martin J C

机构信息

Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.

出版信息

Lasers Med Sci. 2014 Mar;29(2):513-8. doi: 10.1007/s10103-013-1499-7. Epub 2014 Jan 8.

DOI:10.1007/s10103-013-1499-7
PMID:24399461
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3953605/
Abstract

Physicists and medical doctors "speak" different languages. Endovenous laser ablation (EVLA) is a good example in which technology is essential to guide the doctor to the final result: optimal treatment. However, for the doctor, it is by far insufficient just to turn on the knobs of the laser. He should understand what is going on in the varicose vein. On the other hand, the physicist is usually not aware what problems the doctor finds on his road towards improving a new technique. We have tried to bring both languages together in the special on Ins and outs of endovenous laser ablation published in this issue of Lasers in Medical Science. The 13 articles include endovenous related clinical (de Roos 2014; Kockaert and Nijsten 2014; van den Bos and Proebstle 2014) and socioeconomical articles (Kelleher et al 2014), the first paper on the molecular pathophysiologic mechanisms (Heger et al 2014), fiber tips (Stokbroekx et al 2014), the future of EVLA (Rabe 2014), a review of EVLA with some important issues for debate (Malskat et al 2014), an excellent paper on transcutaneous laser therapies of spider and small varicose veins (Meesters et al 2014), as well as several scientific modeling articles, varying from a mathematical model of EVLA that includes the carbonized blood layer on the fiber tip (van Ruijven et al 2014) and its application to the simulation of clinical conditions (Poluektova et al 2014) via experimental measurements of temperature profiles in response to EVLA, radiofrequency waves, and steam injections (Malskat et al 2014) to a literature review and novel physics approach of the absorption and particularly scattering properties of whole blood also including the infrared wavelengths used by EVLA (Bosschaart et al 2014). The aim of our afterthoughts, the 14th article in this special, is to try to amalgamate the clinical and physical contents of these contributions, providing the reader with the bridge that overlaps these different backgrounds.

摘要

物理学家和医生“说”着不同的语言。静脉内激光消融术(EVLA)就是一个很好的例子,在这个例子中,技术对于引导医生获得最终结果(即最佳治疗效果)至关重要。然而,对医生来说,仅仅打开激光设备的旋钮远远不够。他应该了解静脉曲张内部发生了什么。另一方面,物理学家通常并不清楚医生在改进一项新技术的过程中会遇到哪些问题。在本期《激光医学》发表的关于静脉内激光消融术的来龙去脉的专辑中,我们试图将这两种语言结合起来。这13篇文章包括与静脉内相关的临床文章(德罗伊斯,2014年;科卡特和尼伊斯滕,2014年;范登博斯和普罗埃斯特勒,2014年)以及社会经济学文章(凯莱赫等人,2014年),第一篇关于分子病理生理机制的论文(黑格等人,2014年),光纤尖端(斯托克布勒克斯等人,2014年),EVLA的未来(拉贝,2014年),一篇对EVLA的综述以及一些有待辩论的重要问题(马尔斯卡特等人,2014年),一篇关于蜘蛛状和小静脉曲张的经皮激光治疗的优秀论文(米斯特斯等人,2014年),还有几篇科学建模文章,从包含光纤尖端碳化血层的EVLA数学模型(范鲁伊文等人,2014年)及其在临床情况模拟中的应用(波卢埃托娃等人,2014年),到通过对EVLA、射频波和蒸汽注射的温度分布进行实验测量(马尔斯卡特等人,2014年),再到对全血吸收尤其是散射特性(包括EVLA使用的红外波长)的文献综述和新颖物理方法(博斯查特等人,2014年)。我们这篇后记是该专辑中的第14篇文章,目的是尝试融合这些文章中的临床和物理内容,为读者提供一座跨越这些不同背景的桥梁。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/3953605/5dd30fb55f90/10103_2013_1499_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/3953605/5dd30fb55f90/10103_2013_1499_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/3953605/5dd30fb55f90/10103_2013_1499_Fig1_HTML.jpg

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本文引用的文献

1
The future of phlebology.
Lasers Med Sci. 2014 Mar;29(2):509-11. doi: 10.1007/s10103-013-1513-0. Epub 2014 Jan 8.
2
How we started performing endovenous thermal ablation procedures: a personal history.我们如何开始进行静脉内热消融手术:个人经历。
Lasers Med Sci. 2014 Mar;29(2):383-5. doi: 10.1007/s10103-013-1462-7. Epub 2014 Jan 5.
3
Endovenous laser ablation (EVLA): a review of mechanisms, modeling outcomes, and issues for debate.静脉腔内激光消融术(EVLA):作用机制、模拟结果及争议问题综述
[静脉内(微创)治疗静脉曲张的方法:高位结扎和剥脱手术的温和有效替代方案]
Hautarzt. 2020 Jan;71(1):12-19. doi: 10.1007/s00105-019-04520-2.
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The role of laser power and pullback velocity in the endovenous laser ablation efficacy: an experimental study.激光功率和回撤速度在静脉腔内激光消融疗效中的作用:一项实验研究。
Lasers Med Sci. 2017 Jul;32(5):1105-1110. doi: 10.1007/s10103-017-2214-x. Epub 2017 May 2.
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Investigation of endovenous laser ablation of varicose veins in vitro using 1.885-μm laser radiation.使用1.885微米激光辐射进行体外静脉曲张腔内激光消融的研究。
Lasers Med Sci. 2016 Apr;31(3):503-10. doi: 10.1007/s10103-016-1877-z. Epub 2016 Feb 12.
Lasers Med Sci. 2014 Mar;29(2):393-403. doi: 10.1007/s10103-013-1480-5. Epub 2013 Dec 24.
4
Commonly used fiber tips in endovenous laser ablation (EVLA): an analysis of technical differences.腔内激光消融术(EVLA)中常用的光纤尖端:技术差异分析
Lasers Med Sci. 2014 Mar;29(2):501-7. doi: 10.1007/s10103-013-1475-2. Epub 2013 Dec 13.
5
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