Mese Bulent, Bozoglan Orhan, Eroglu Erdinc, Erdem Kemalettin, Acipayam Mehmet, Ekerbicer Hasan Cetin, Yasim Alptekin
Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Ann Vasc Surg. 2015 Oct;29(7):1368-72. doi: 10.1016/j.avsg.2015.03.063. Epub 2015 Jun 27.
To compare 1,470-nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in the treatment of patients with great saphenous vein diameters of 10 mm or more.
One hundred twenty consecutive patients presenting to the cardiovascular surgery department with a great saphenous vein diameter exceeding 10 mm at the saphenofemoral junction between January and December 2013 were included in the study. The first randomly selected 60 patients (group 1) received 1,470-nm EVLA and the other 60 patients (group 2) received RFA. Patients were assessed on the second day, the first week, and the first, third, and sixth months. Major and minor complications were recorded.
Minor complications in EVLA and RFA were hyperemia at 20% and 30% (P = 0.50), ecchymosis at 16.7% and 48.3% (P = 0.02), and edema at 40.0% and 65.5% (P < 0.08), respectively. No major complication was observed in any patient. Recanalization developed during monitoring in 3 patients in the RFA group, a rate of 5%. No recanalization was observed in the EVLA group. Success rates in the EVLA and RFA groups were 100% and 95%, respectively. Mean time to return to daily activity was 0.7 days in the EVLA group and 1.4 days in the RFA group (P < 0.006), whereas mean time to return to work was 1.8 days in the EVLA group and 2.2 days in the RFA group (P < 0.07). There was no statistically significant difference between the groups in terms of pain during the procedure or postoperatively. Less pain was reported in the EVLA during both (P < 0.02).
EVLA using a 1,470-nm radial fiber is superior to RFA in the treatment of saphenous veins larger than 10 mm in diameter.
比较1470纳米腔内激光消融术（EVLA）与射频消融术（RFA）治疗大隐静脉直径10毫米及以上患者的效果。
纳入2013年1月至12月间连续120例就诊于心血管外科、大隐静脉在隐股交界处直径超过10毫米的患者。随机选取60例患者（第1组）接受1470纳米EVLA治疗，另外60例患者（第2组）接受RFA治疗。在术后第二天、第一周以及第一、第三和第六个月对患者进行评估。记录主要和次要并发症。
EVLA和RFA的次要并发症中，充血分别为20%和30%（P = 0.50），瘀斑分别为16.7%和48.3%（P = 0.02），水肿分别为40.0%和65.5%（P < 0.08）。所有患者均未观察到主要并发症。RFA组在监测期间有3例出现再通，发生率为5%。EVLA组未观察到再通。EVLA组和RFA组的成功率分别为100%和95%。EVLA组恢复日常活动的平均时间为0.7天，RFA组为1.4天（P < 0.006）；而EVLA组恢复工作的平均时间为1.8天，RFA组为2.2天（P < 0.07）。两组在手术过程中或术后的疼痛方面无统计学显著差异。但在这两方面，EVLA组报告的疼痛较少（P < 0.02）。
使用1470纳米径向光纤的EVLA在治疗直径大于10毫米的大隐静脉方面优于RFA。
