Real time echo-guided endolaser for thermal ablation without perivenous tumescence

Detalhes bibliográficos
Autor(a) principal: Gaspar,Ricardo José
Data de Publicação: 2015
Outros Autores: Castro,André Nóbrega, Simões,Manuel de Jesus, Plapler,Hélio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Vascular Brasileiro (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492015000400290
Resumo: Abstract Background There is no consensus in the medical literature on the ideal procedure for endovenous laser application. Objective To assess the safety and efficacy of real time echo-guided endovenous laser for thermal ablation of great saphenous vein (GSV) incompetence, without perivenous tumescence. Methods Thirty-four limbs of patients with CEAP clinical scores of 2 to 6 and bilateral incompetence of the saphenofemoral junction (SFJ) and GSV, confirmed by Echo-Doppler, underwent endovenous laser therapy and were followed for 1 year. Laser ablation was performed using a 600 µ bare optical fiber introduced endovenously close to the malleolus along the full extent of the GSV in an anterograde direction, using a standardized echo-Doppler-guided AND? 15 watt continuous mode 980 nm diode laser with real-time monitoring of thermal ablation of the whole target vein. Adverse effects and complications were recorded. Results Hyperesthesia, cellulitis, and fibrous cord, all transitory, developed in 2.9% of the 34 limbs treated; 8.8% developed hypoesthesia in the perimalleolar region, which was transitory and had no clinical consequences; there were no cases of deep venous thrombosis. Immediate occlusion was achieved in 100% of the 34 saphenous veins that underwent photocoagulation, although one exhibited recanalization without reflux at 1-month follow-up. After 6 months and 1 year, occlusion was 100% according to echo-Doppler findings. Conclusions Real-time echo-guided 980 nm endovenous laser ablation without perivenous tumescence provided controlled thermal ablation with safe, effective, immediate and medium-term GSV occlusion and can therefore be recommended as a method for the treatment of chronic venous disease.
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spelling Real time echo-guided endolaser for thermal ablation without perivenous tumescencevaricose veinsvenous insufficiencysaphenous veinlaser therapyAbstract Background There is no consensus in the medical literature on the ideal procedure for endovenous laser application. Objective To assess the safety and efficacy of real time echo-guided endovenous laser for thermal ablation of great saphenous vein (GSV) incompetence, without perivenous tumescence. Methods Thirty-four limbs of patients with CEAP clinical scores of 2 to 6 and bilateral incompetence of the saphenofemoral junction (SFJ) and GSV, confirmed by Echo-Doppler, underwent endovenous laser therapy and were followed for 1 year. Laser ablation was performed using a 600 µ bare optical fiber introduced endovenously close to the malleolus along the full extent of the GSV in an anterograde direction, using a standardized echo-Doppler-guided AND? 15 watt continuous mode 980 nm diode laser with real-time monitoring of thermal ablation of the whole target vein. Adverse effects and complications were recorded. Results Hyperesthesia, cellulitis, and fibrous cord, all transitory, developed in 2.9% of the 34 limbs treated; 8.8% developed hypoesthesia in the perimalleolar region, which was transitory and had no clinical consequences; there were no cases of deep venous thrombosis. Immediate occlusion was achieved in 100% of the 34 saphenous veins that underwent photocoagulation, although one exhibited recanalization without reflux at 1-month follow-up. After 6 months and 1 year, occlusion was 100% according to echo-Doppler findings. Conclusions Real-time echo-guided 980 nm endovenous laser ablation without perivenous tumescence provided controlled thermal ablation with safe, effective, immediate and medium-term GSV occlusion and can therefore be recommended as a method for the treatment of chronic venous disease.Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)2015-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492015000400290Jornal Vascular Brasileiro v.14 n.4 2015reponame:Jornal Vascular Brasileiro (Online)instname:Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)instacron:SBACV10.1590/1677-5449.07214info:eu-repo/semantics/openAccessGaspar,Ricardo JoséCastro,André NóbregaSimões,Manuel de JesusPlapler,Hélioeng2015-12-08T00:00:00Zoai:scielo:S1677-54492015000400290Revistahttp://www.scielo.br/jvbhttps://old.scielo.br/oai/scielo-oai.php||secretaria@sbacv.org.br1677-73011677-5449opendoar:2015-12-08T00:00Jornal Vascular Brasileiro (Online) - Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)false
dc.title.none.fl_str_mv Real time echo-guided endolaser for thermal ablation without perivenous tumescence
title Real time echo-guided endolaser for thermal ablation without perivenous tumescence
spellingShingle Real time echo-guided endolaser for thermal ablation without perivenous tumescence
Gaspar,Ricardo José
varicose veins
venous insufficiency
saphenous vein
laser therapy
title_short Real time echo-guided endolaser for thermal ablation without perivenous tumescence
title_full Real time echo-guided endolaser for thermal ablation without perivenous tumescence
title_fullStr Real time echo-guided endolaser for thermal ablation without perivenous tumescence
title_full_unstemmed Real time echo-guided endolaser for thermal ablation without perivenous tumescence
title_sort Real time echo-guided endolaser for thermal ablation without perivenous tumescence
author Gaspar,Ricardo José
author_facet Gaspar,Ricardo José
Castro,André Nóbrega
Simões,Manuel de Jesus
Plapler,Hélio
author_role author
author2 Castro,André Nóbrega
Simões,Manuel de Jesus
Plapler,Hélio
author2_role author
author
author
dc.contributor.author.fl_str_mv Gaspar,Ricardo José
Castro,André Nóbrega
Simões,Manuel de Jesus
Plapler,Hélio
dc.subject.por.fl_str_mv varicose veins
venous insufficiency
saphenous vein
laser therapy
topic varicose veins
venous insufficiency
saphenous vein
laser therapy
description Abstract Background There is no consensus in the medical literature on the ideal procedure for endovenous laser application. Objective To assess the safety and efficacy of real time echo-guided endovenous laser for thermal ablation of great saphenous vein (GSV) incompetence, without perivenous tumescence. Methods Thirty-four limbs of patients with CEAP clinical scores of 2 to 6 and bilateral incompetence of the saphenofemoral junction (SFJ) and GSV, confirmed by Echo-Doppler, underwent endovenous laser therapy and were followed for 1 year. Laser ablation was performed using a 600 µ bare optical fiber introduced endovenously close to the malleolus along the full extent of the GSV in an anterograde direction, using a standardized echo-Doppler-guided AND? 15 watt continuous mode 980 nm diode laser with real-time monitoring of thermal ablation of the whole target vein. Adverse effects and complications were recorded. Results Hyperesthesia, cellulitis, and fibrous cord, all transitory, developed in 2.9% of the 34 limbs treated; 8.8% developed hypoesthesia in the perimalleolar region, which was transitory and had no clinical consequences; there were no cases of deep venous thrombosis. Immediate occlusion was achieved in 100% of the 34 saphenous veins that underwent photocoagulation, although one exhibited recanalization without reflux at 1-month follow-up. After 6 months and 1 year, occlusion was 100% according to echo-Doppler findings. Conclusions Real-time echo-guided 980 nm endovenous laser ablation without perivenous tumescence provided controlled thermal ablation with safe, effective, immediate and medium-term GSV occlusion and can therefore be recommended as a method for the treatment of chronic venous disease.
publishDate 2015
dc.date.none.fl_str_mv 2015-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492015000400290
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492015000400290
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/1677-5449.07214
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
publisher.none.fl_str_mv Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
dc.source.none.fl_str_mv Jornal Vascular Brasileiro v.14 n.4 2015
reponame:Jornal Vascular Brasileiro (Online)
instname:Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
instacron:SBACV
instname_str Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
instacron_str SBACV
institution SBACV
reponame_str Jornal Vascular Brasileiro (Online)
collection Jornal Vascular Brasileiro (Online)
repository.name.fl_str_mv Jornal Vascular Brasileiro (Online) - Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
repository.mail.fl_str_mv ||secretaria@sbacv.org.br
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