Viarengo Luiz Marcelo Aiello, Viarengo Gabriel, Martins Aline Meira, Mancini Marília Wechellian, Lopes Luciana Almeida
Clínica Viarengo - CV, Jundiaí, SP, Brasil.
Núcleo de Pesquisa e Ensino de Fototerapia nas Ciências da Saúde - NUPEN, São Carlos, SP, Brasil.
J Vasc Bras. 2017 Jan-Mar;16(1):23-30. doi: 10.1590/1677-5449.010116.
Introduction of the endovenous laser technique for treatment of varicose veins triggered a efforts to identify an ideal wavelength, capable of producing the highest possible selective damage with the greatest safety and lowest incidence of adverse effects.
Assess medium to long term results of 1940nm diode laser treatment of varicose veins, correlating parameters used with durability of the anatomic outcome.
This was a retrospective study of patients diagnosed with Chronic Venous Insufficiency at clinical stages CEAP C2 to C6 who underwent thermoablative treatment of trunk varicose veins using a 1940nm wavelength laser with a radial emission optical fiber, from April 2012 to July 2015. A systematic review was conducted of electronic medical records to obtain demographic and clinical data, including postoperative follow-up duplex ultrasound findings.
The average age of the 41-patient sample was 53.3 years and 37 patients were women (90.2%). The average follow-up time was 803 days. The average caliber of the treated veins was 7.8 mm. The immediate success rate was 100% with an average LEED of 45.3 J/cm. The late success rate was 95.1%, and two recanalizations were observed around 12 months after ablation. There was no recanalization in veins treated with a LEED greater than 30 J/cm.
The 1940nm laser proved to be safe and effective in venous segments up to 10 mm in diameter, with the parameters proposed, over medium to long term time follow-up.
静脉内激光技术用于治疗静脉曲张引发了人们努力寻找一种理想波长，该波长能够在最大程度保证安全且不良反应发生率最低的情况下产生尽可能高的选择性损伤。
评估1940nm二极管激光治疗静脉曲张的中长期效果，将所使用的参数与解剖学结果的持久性相关联。
这是一项对2012年4月至2015年7月期间临床分期为CEAP C2至C6且被诊断为慢性静脉功能不全的患者进行的回顾性研究，这些患者使用带有径向发射光纤的1940nm波长激光对主干静脉曲张进行热消融治疗。对电子病历进行系统回顾以获取人口统计学和临床数据，包括术后随访的双功超声检查结果。
41例患者样本的平均年龄为53.3岁，37例为女性（90.2%）。平均随访时间为803天。治疗静脉的平均管径为7.8mm。即刻成功率为100%，平均激光能量密度为45.3J/cm。晚期成功率为95.1%，在消融后约12个月观察到2例再通。激光能量密度大于30J/cm的静脉未出现再通。
在中长期随访中，所提出的参数下，1940nm激光在直径达10mm的静脉段中被证明是安全有效的。
