Shaĭdakov E V, Sannikov A B, Emel'ianenko V M, Solokhin S A, Zubov B V, Pashinin A D, Karpenko M V, Morozova O N
Educational and Methodological Division, Institute of Human Brain named after N.P. Bekhtereva, Russian Academy of Sciences, Saint Petersburg, Russia.
Department of Additional Professional Education of Healthcare Specialists, N.I. Pirogov Russian National Research Medical University, Moscow, Russia.
Angiol Sosud Khir. 2020;26(2):110-116. doi: 10.33529/ANGIO2020223.
Amongst the techniques of endoluminal thermal obliteration of varicose veins, the most commonly employed treatment modalities are endovasal radiofrequency ablation and endovasal laser obliteration, both using a generating source and a special device for carrying out thermal obliteration. It has been noted that each of the methods of thermal obliteration has a number of disadvantages, irrespective of using the energy of magnetic oscillations in a radiofrequency range or laser radiation, including high cost of expendable materials and equipment. The device we worked out for endoluminal thermal obliteration of varicose veins was based on the principle of high efficacy and safety, with a significant decrease in the cost of carrying out the manipulation. This was achieved by means of developing a new device wherein a thermal effect is exerted not via the direct impact of laser radiation on the venous wall but at the expense of using laser energy exceptionally for heating a metal tip located at the distal end of high-strength metallized fibre coated with a heat-resistant polymer. Analysing the initial short-term results of using the new technique of thermal obliteration in treating a total of 50 patients presenting with varicose veins made it possible to draw a conclusion on high efficacy of the method and its safety. The proposed device may repeatedly be used with any and simplest-in-design source of laser radiation regardless of the wavelength and power of radiation. Implementation of this technique into clinical practice will make it possible to decrease manifold the cost of the procedure of thermal obliteration of varicose veins, currently carried out with the use of the classic techniques - endovasal laser obliteration and endovasal radiofrequency ablation.
在腔内热消融治疗静脉曲张的技术中，最常用的治疗方式是腔内射频消融和腔内激光消融，两者都使用一个产生源和一种进行热消融的特殊装置。值得注意的是，无论使用射频范围内的磁振荡能量还是激光辐射，每种热消融方法都有许多缺点，包括消耗材料和设备成本高昂。我们研发的用于腔内热消融治疗静脉曲张的装置基于高效和安全的原则，显著降低了操作成本。这是通过开发一种新装置实现的，在该装置中，热效应不是通过激光辐射对静脉壁的直接作用产生，而是仅利用激光能量加热位于高强度金属化纤维远端且涂有耐热聚合物的金属尖端。分析使用这种新的热消融技术治疗总共50例静脉曲张患者的初步短期结果，可以得出该方法具有高效性和安全性的结论。所提出的装置可以与任何设计最简单的激光辐射源反复使用，而不管辐射的波长和功率如何。将该技术应用于临床实践将有可能大幅降低目前使用经典技术（腔内激光消融和腔内射频消融）进行静脉曲张热消融手术的成本。
