Movio Leonardo Zelotti, Mansano Marco Antônio Forastieri, Zanoni Marcelo Eckert, Silva Nancy Christiane Ferreira, Rangel Marcel Pereira
Universidade Cesumar - UniCesumar, Maringá, PR, Brasil.
Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil.
J Vasc Bras. 2023 Jul 21;22:e20210181. doi: 10.1590/1677-5449.202101812. eCollection 2023.
Use of endolaser for chronic venous disease involves choosing the laser wavelength and optical fiber to use and the quantity of energy to be administered. Efficacy is assessed by the venous occlusion rate and safety is evaluated in terms of side effects.
To determine the incidence of total post-endolaser saphenous vein occlusion at 1-year follow-up. To describe side effects and their incidence and rates of reintervention or supplementary treatment during the postoperative period.
A retrospective, observational cohort study with a quantitative approach, enrolling patients with saphenous vein incompetence treated with intravenous 1,470 nm laser ablation. Data were input to an MS Excel 2019 spreadsheet, calculating means and standard deviations with the software's Power Query supplement.
38 patients and 104 venous segments were eligible for the study. 100% were occluded at 30 days and 99.04% were still occluded at 1 year after the procedure. Mean Linear Endovenous Energy Density administered to the internal saphenous vein was 2,040.52 W/cm/s with standard deviation of ± 1,510.06 W/cm/s and 1,168.4 W/cm/s with standard deviation of ± 665.011 W/cm/s was administered to the external saphenous vein. Pain along the saphenous path was the most common side effect, with eight cases (21.05%), followed by one case of paresthesia (2.63%).
The total occlusion rate at 1-year follow-up suggests the technique is promising and is currently applicable in this sample. The incidence of pain and paresthesia may be caused by the high mean energy delivered in some cases. It is recommended that multicenter studies be conducted with larger and more uniform samples in terms of their Clinical-Etiological-Anatomical-Pathological classifications.
腔内激光治疗慢性静脉疾病涉及选择激光波长、使用的光纤以及要施加的能量量。疗效通过静脉闭塞率评估，安全性根据副作用进行评价。
确定腔内激光治疗大隐静脉术后1年随访时完全闭塞的发生率。描述术后期间的副作用及其发生率以及再次干预或补充治疗的比率。
一项采用定量方法的回顾性观察队列研究，纳入接受静脉内1470nm激光消融治疗的大隐静脉功能不全患者。数据输入到MS Excel 2019电子表格中，使用该软件的Power Query补充功能计算均值和标准差。
38例患者和104条静脉段符合研究条件。术后30天时100%的静脉段闭塞，术后1年时仍有99.04%闭塞。大隐静脉内平均线性静脉能量密度为2040.52W/cm/s，标准差为±1510.06W/cm/s；小隐静脉内平均线性静脉能量密度为1168.4W/cm/s，标准差为±665.011W/cm/s。沿大隐静脉走行的疼痛是最常见的副作用，有8例（21.05%），其次是1例感觉异常（2.63%）。
1年随访时的完全闭塞率表明该技术很有前景，目前适用于本样本。疼痛和感觉异常的发生率可能是由某些病例中较高的平均能量传递所致。建议开展多中心研究，纳入临床-病因-解剖-病理分类更大型且更统一的样本。
