Aktas Aykut Recep, Celik Orhan, Ozkan Ugur, Cetin Mustafa, Koroglu Mert, Yilmaz Sevda, Daphan Birsen U, Oguzkurt Levent
Department of Radiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey,
Lasers Med Sci. 2015 Jul;30(5):1583-7. doi: 10.1007/s10103-015-1768-8. Epub 2015 May 20.
The purpose of this study was to compare the effectiveness of 1470- and 980-nm lasers with regard to power output, complications, recanalization rates, and treatment response. We prospectively evaluated the effectiveness of endovenous laser ablation (EVLA) in a total of 152 great and small saphenous veins from 96 patients. Lasers were randomly used based on the availability of the units. Patients were clinically evaluated for Clinical Etiologic Anatomic Pathophysiologic (CEAP) stage and examined with Doppler ultrasound. Treatment response was determined anatomically by occlusion of the vein and clinically by the change in the venous clinical severity score (VCSS). Seventy-eight of the saphenous veins underwent EVLA with a 980-nm laser and 74 underwent EVLA with a 1470-nm laser. Treatment response was (68) 87.2 % in the 980-nm group and (74) 100 % in the 1470-nm group (p = 0.004). The median VCSS decreased from 4 to 2 in the 980-nm group (p < 0.001) and from 8 to 2 (p < 0.001) in the 1470-nm group. At 1-year follow-up, seven veins treated with 980 nm and two veins treated with 1470 nm were recanalized (p = 0.16); the average linear endovenous energy density (LEED) was 83.9 (r, 55-100) J/cm and 58.5 (r, 45-115) J/cm, respectively (p < 0.001). Postoperative minor complications occurred in 23 (29.4 %) limbs in the 980-nm group and in 19 (25.6 %) limbs of the 1470-nm group (p = 0.73). EVLA with the 1470-nm laser have less energy deposition for occlusion and better treatment response.
本研究的目的是比较1470纳米和980纳米激光在功率输出、并发症、再通率和治疗反应方面的有效性。我们前瞻性地评估了96例患者共152条大隐静脉和小隐静脉的腔内激光消融（EVLA）有效性。根据设备的可用性随机使用激光。对患者进行临床病因解剖病理生理（CEAP）分期评估，并采用多普勒超声检查。通过静脉闭塞在解剖学上确定治疗反应，并通过静脉临床严重程度评分（VCSS）的变化在临床上确定治疗反应。78条隐静脉接受了980纳米激光的EVLA治疗，74条接受了1470纳米激光的EVLA治疗。980纳米组的治疗反应率为（68/78）87.2%，1470纳米组为（74/74）1OO%（p = 0.004）。980纳米组的VCSS中位数从4降至2（p < 0.001），1470纳米组从8降至2（p < 0.001）。在1年随访时，980纳米治疗的7条静脉和1470纳米治疗的2条静脉发生再通（p = 0.16）；平均线性腔内能量密度（LEED）分别为83.9（范围55 - 100）J/cm和58.5（范围45 - 115）J/cm（p < 0.001）。980纳米组23例（29.4%）肢体出现术后轻微并发症，1470纳米组19例（25.6%）肢体出现术后轻微并发症（p = 0.73）。1470纳米激光的EVLA闭塞所需的能量沉积较少，治疗反应更好。
