Starodubtsev Vladimir, Lukyanenko Mikhail, Karpenko Andrey, Ignatenko Pavel
Novosibirsk State Budget Research Institute of Circulation Pathology, Ministry for Public Healthcare of the Russian Federation, Novosibirsk, Russia -
Novosibirsk State Budget Research Institute of Circulation Pathology, Ministry for Public Healthcare of the Russian Federation, Novosibirsk, Russia.
Int Angiol. 2017 Aug;36(4):368-374. doi: 10.23736/S0392-9590.17.03779-8. Epub 2017 Jan 31.
The aim of study was to estimate the safety and efficacy of using laser wavelength of 1560 nm with the foam sclerotherapy (FS) of varicose veins (VVs) for the treatment of severe primary chronic venous insufficiency (CVI, C4-C6) in patients with different diameters of the proximal segment (DPS) of the great saphenous vein (GSV).
We have separated the patients into two groups depending on the size of GSV: group 1 (281 cases; DPS of GSV less than 15 mm) and group 2 (210 cases; DPS of GSV more than 15 mm). Both groups received the endovenous laser ablation (EVLA) of the saphenous vein trunk, incompetent perforator veins (IPs) and FS (Tessari method) of VVs. The linear endovenous energy density (LEED) was personalized depending on the vein size.
The healing of ulcers and resolution of venous eczema in 6 months were considered the primary end-point. Healing of ulcers was found in 45/55 (82%) cases in group 1 and in 31/35 (88%) cases in group 2. The resolution of venous eczema in 56 (80%) from 70 cases in group 1 and 45 (85%) from 53 cases in group 2 was observed. Leg ulcer recurrence at 3 years' follow-up in 7.3% cases in group 1 and 8.6% cases in group 2 was determined.
Our experience of using laser wavelength of 1560 nm and FS of VVs for the treatment of severe primary CVI shows the safety and efficacy of this technique in patients with different DPS of GSV.
本研究的目的是评估使用1560 nm激光波长联合泡沫硬化疗法（FS）治疗大隐静脉（GSV）不同近端段直径（DPS）患者的严重原发性慢性静脉功能不全（CVI，C4 - C6）的安全性和有效性。
根据GSV的大小将患者分为两组：第1组（281例；GSV的DPS小于15 mm）和第2组（210例；GSV的DPS大于15 mm）。两组均接受大隐静脉主干、功能不全的交通静脉（IPs）的腔内激光消融（EVLA）以及VVs的FS（泰萨里法）。线性腔内能量密度（LEED）根据静脉大小进行个体化设定。
6个月内溃疡愈合和静脉性湿疹消退被视为主要终点。第1组55例中有45例（82%）溃疡愈合，第2组35例中有31例（88%）溃疡愈合。第1组70例中有56例（80%）静脉性湿疹消退，第2组53例中有45例（85%）静脉性湿疹消退。在3年随访中，第1组7.3%的病例和第2组8.6%的病例出现腿部溃疡复发。
我们使用1560 nm激光波长和VVs的FS治疗严重原发性CVI的经验表明，该技术在GSV不同DPS的患者中具有安全性和有效性。
