WJCS  Vol.4 No.11 , November 2014
Higher Energy Does Not Mean Better Outcome Following Endovenous Laser Ablation of Great Saphenous Vein
ABSTRACT
Background: Endovenous laser ablation is a relatively newer alternative to treat great saphenous vein insufficiency. We evaluated the efficiency and safety of treatment endovenous laser procedures on the different saphenous vein diameters with different energy levels. Methods: Data regarding endovenous laser ablation of symptomatic chronic great saphenous venous insufficiency in 209 patients were prospectively recorded. Patients were grouped into two main groups based on their diameters as 5 to 7 millimeters (Group A) or more than 7 millimeters (Group B). Patients in each group was randomized into two groups as >90 J/cm (A1 and B1) or 80-90 J/cm (A2 and B2). Postoperative outcome and complications were recorded during follow-ups at 1st week; 1st, 3rd and 6th months to examine the venous reflux and recanalization. Results: Perioperative complaints as pain, cramps and ankle swelling were more commonly observed in A1 group. Fatigue was more common in A2 and B2 groups. No major complications as deep vein thrombosis or skin burns were observed. Conclusions: Endovenous laser ablation is a safe and effective procedure with a high satisfaction rate shortening hospitalization durations and early ambulant activity. Pain, ankle swelling and fatigue are the most common minor complaints in the early postoperative period.

Cite this paper
Karatepe, C. , Aldemir, M. , Çınar, B. , Önalan, A. , Issever, H. and Goksel, O. (2014) Higher Energy Does Not Mean Better Outcome Following Endovenous Laser Ablation of Great Saphenous Vein. World Journal of Cardiovascular Surgery, 4, 200-205. doi: 10.4236/wjcs.2014.411029.
References
[1]   Carpentier, P.H., Maricq, H.R., Biro, C., et al. (2004) Prevalence, Risk Factors and Clinical Patterns of Chronic Venous Disorders of Lower Limbs: A Population-Based Study in France. Journal of Vascular Surgery, 40, 650-659.
http://dx.doi.org/10.1016/j.jvs.2004.07.025

[2]   Sisto, T., Reunanen, A., Laurikka, J., et al. (1995) Prevalence and Risk Factors of Varicose Veins in Lower Extremities: Mini-Finland Health Survey. European Journal of Surgical Oncology, 161, 405-414.

[3]   Evans, C.J., Fowkes, F.G., Ruckley, C.V., et al. (1999) Prevalence of Varicose Veins and Chronic Venous Insufficiency in Men and Women in the General Population: Edinburgh Vein Study. Journal of Epidemiology and Community Health, 53, 149-153.
http://dx.doi.org/10.1136/jech.53.3.149

[4]   Jawien, A., Grzela, T. and Ochwat, A. (2003) Prevalence of Chronic Venous Insufficiency in Men and Women in Poland: Multicentre Cross-Sectional Study in 40,095 Patients. Phlebology, 18, 110-122.
http://dx.doi.org/10.1258/026835503322381315

[5]   Nelzén, O., Bergqvist, D. and Lindhagen, A. (1994) Venous and Non-Venous Leg Ulcers: Clinical History and Appearance in a Population Study. British Journal of Surgery, 81, 182-187.
http://dx.doi.org/10.1002/bjs.1800810206

[6]   Wright, D.D., Franks, P.J., Blair, S.D., et al. (1991) Oxerutins in the Prevention of Recurrence in Chronic Venous Ulceration: Randomized Controlled Trial. British Journal of Surgery, 78, 1269-1270.
http://dx.doi.org/10.1002/bjs.1800781039

[7]   Ragnarson Tennvall, G. and Hjelmgren, J. (2005) Annual Costs of Treatment for Venous Leg Ulcers in Sweden and the United Kingdom. Wound Repair and Regeneration, 13, 13-18.
http://dx.doi.org/10.1111/j.1067-1927.2005.130103.x

[8]   Jantet, G. (1992) Impact socio-économique de la pathologie veineuse en Grande Bretagne. Phlébologie, 45, 433-437.

[9]   Subramonia, S. and Lees, T. (2005) Sensory Abnormalities and Bruising after Long Saphenous Vein Stripping: Impact on Short-Term Quality of Life. Journal of Vascular Surgery, 42, 510-514.
http://dx.doi.org/10.1016/j.jvs.2005.05.021

[10]   Wood, J.J., Chant, H., Laugharne, M., et al. (2005) A Prospective Study of Cutaneous Nerve Injury Following Long Saphenous Vein Surgery. European Journal of Vascular and Endovascular Surgery, 30, 654-658.
http://dx.doi.org/10.1016/j.ejvs.2005.06.009

[11]   Morrison, C. and Dalsing, M.C. (2003) Signs and Symptoms of Saphenous Nerve Injury after Greater Saphenous Vein Stripping: Prevalence, Severity, and Relevance for Modern Practice. Journal of Vascular Surgery, 38, 886-890.
http://dx.doi.org/10.1016/S0741-5214(03)00790-0

[12]   Davies, A.H., Steffen, C., Cosgrove, C. and Wilkins, D.C. (1995) Varicose Vein Surgery: Patient Satisfaction. Journal of the Royal College of Surgeons of Edinburgh, 40, 298-299.

[13]   Mackay, D.C., Summerton, D.J. and Walker, A.J. (1995) The Early Morbidity of Varicose Vein Surgery. Journal of the Royal Naval Medical Service, 81, 42-46.

[14]   Critchley, G., Handa, A., Maw, A., Harvey, A., Harvey, M.R. and Corbett, C.R. (1997) Complications of Varicose Vein Surgery. Annals of the Royal College of Surgeons of England, 79, 105-110.

[15]   Miller, G.V., Lewis, W.G., Sainsbury, J.R. and Macdonald, R.C. (1996) Morbidity of Varicose Vein Surgery: Auditing the Benefit of Changing Clinical Practice. Annals of the Royal College of Surgeons of England, 78, 345-349.

[16]   Kostas, T., Ioannou, C.V., Touloupakis, E., Daskalaki, E., Giannoukas, A.D., Tsetis, D., et al. (2004) Recurrent Varicose Veins after Surgery: A New Appraisal of a Common and Complex Problem in Vascular Surgery. European Journal of Vascular and Endovascular Surgery, 27, 275-282.

[17]   van Rij, A.M., Jiang, P., Solomon, C., Christie, R.A. and Hill, G.B. (2003) Recurrence after Varicose Vein Surgery: A Prospective Long-Term Clinical Study with Duplex Ultrasound Scanning and Air Plethysmography. Journal of Vascular Surgery, 38, 935-943.
http://dx.doi.org/10.1016/S0741-5214(03)00601-3

[18]   Fischer, R., Linde, N., Duff, C., Jeanneret, C., Chandler, J.G. and Seeber, P. (2001) Late Recurrent Saphenofemoral Junction Reflux after Ligation and Stripping of the Greater Saphenous Vein. Journal of Vascular Surgery, 34, 236-240.
http://dx.doi.org/10.1067/mva.2001.115802

[19]   Lohr, J. and Kulwicki, A. (2010) Radiofrequency Ablation: Evolution of a Treatment. Seminars in Vascular Surgery, 23, 90-100.
http://dx.doi.org/10.1053/j.semvascsurg.2010.01.004

[20]   Johonson, G. and Rutherford, R.B. (1995) Varicose Veins: Patient Selection and Treatment. In: Rutherford, R.B., Ed., Vascular Surgery, 4th Edition, W.B. Saunders, Philadelphia, 1825-1828.

[21]   Neser, R.A. and Caffaro, R.A. (2011) Invagination Stripping with Ultrasound-Guided Perivenous Tumescence: An Original Method of Great Saphenous Vein Stripping. Dermatologic Surgery, 37, 349-352.
http://dx.doi.org/10.1111/j.1524-4725.2011.01885.x

[22]   Skykes, T.C., Brookes, P. and Hickey, N.C. (2000) A Prospective Randomized Trial of Tourniquet in Varicose Vein Surgery. Annals of the Royal College of Surgeons of England, 82, 280-282.

[23]   Proebstle, T.M., Moehler, T. and Herdemann, S. (2006) Reduced Recanalization Rates of the Great Saphenous Vein after Endovenous Laser Treatment with Increased Energy Dosing: Definition of a Threshold for the Endovenous Fluence Equivalent. Journal of Vascular Surgery, 44, 834-839.
http://dx.doi.org/10.1016/j.jvs.2006.05.052

[24]   Nisar, A., Shabbir, J., Tubassam, M.A., Shah, A.R., Khawaia, N., Kavanagh, E.G., et al. (2006) Local Anaesthetic Flush Reduces Postoperative Pain and Haematoma Formation after Great Saphenous Vein Stripping—A Randomized Controlled Trial. European Journal of Vascular and Endovascular Surgery, 31, 325-331.
http://dx.doi.org/10.1016/j.ejvs.2005.08.006

[25]   Min, R.J., Khilnani, N. and Zimmet, S.E. (2003) Endovenous Laser Treatment of Saphenous Vein Reflux: Long-Term Results. Journal of Vascular and Interventional Radiology, 14, 991-996.
http://dx.doi.org/10.1097/01.RVI.0000082864.05622.E4

[26]   Sharif, M.A., Soong, C.V., Lau, L.L., Corvan, R., Lee, B. and Hannon, R.J. (2006) Endovenous Laser Treatment for Long Saphenous Vein Incompetence. British Journal of Surgery, 93, 831-835.
http://dx.doi.org/10.1002/bjs.5351

 
 
Top