Hirokawa Masayuki, Utoh Junichi, Sugiyama Satoru, Suzuki Osamu, Yamamoto Takashi, Ogawa Tomohiro, Mo Makoto
Ochanomizu Vascular and Vein Clinic, Tokyo, Japan.
Kumamoto Vascular Clinic, Kumamoto, Kumamoto, Japan.
Ann Vasc Dis. 2025;18(1). doi: 10.3400/avd.gl.25-00053. Epub 2025 Jun 6.
In the treatment of saphenous varicose veins with endovenous laser ablation, simultaneous treatment of varicose tributaries using stab avulsion or sclerotherapy is commonly performed. To address the limitations of these conventional treatments, laser ablation for varicose tributaries has recently gained widespread acceptance. This guideline, developed by the Japanese Society of Phlebology, outlines appropriate treatment protocols for laser ablation of varicose tributaries. Indications include primary varicose veins requiring concurrent treatment of the saphenous trunk and varicose tributaries. The procedure utilizes slim radial fibers, with puncture and ablation performed using either short- or long-axis approaches. Although rare, adverse events such as skin burns, nerve injury, and fiber breakage have been reported. A learning curve is necessary to ensure the safe execution of the procedure. Further clinical studies are essential to enhance the safety and efficacy of laser ablation for varicose tributaries. (This is a secondary publication from Jpn J Phlebol 2025; 36: 51-58.).
在采用静脉腔内激光消融术治疗大隐静脉曲张时，通常会同时使用点状剥脱术或硬化疗法来治疗曲张属支。为解决这些传统治疗方法的局限性，近年来，用于治疗曲张属支的激光消融术已得到广泛认可。本指南由日本静脉病学会制定，概述了曲张属支激光消融术的适当治疗方案。适应症包括需要同时治疗大隐静脉主干和曲张属支的原发性静脉曲张。该手术使用纤细的径向光纤，采用短轴或长轴方法进行穿刺和消融。尽管罕见，但已报告了诸如皮肤烧伤、神经损伤和光纤断裂等不良事件。为确保手术安全实施，需要经历学习曲线。进一步的临床研究对于提高曲张属支激光消融术的安全性和有效性至关重要。（本文为《日本静脉病学杂志》2025年；36: 51 - 58的二次发表文章。）
