OUR EXPERIENCE WITH ENDOVENOUS LASER THERAPY FOR VARICOSE VEINS

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Background: The surgical management of varicose veins has been subject to radical change due to both the effective use of endovenous laser therapy (EVLT) and greater knowledge regarding the venous haemodynamics of the lower limbs.
Aim: The aim of our study was to evaluate the results of varicose vein treatment using EVLT. Based on our results we discuss the use of laser, the appropriate use of crossectomy (a ligation and dissection of the great saphenous vein and its tributaries), and deduce the amount of energy required for the occlusion of treated veins.
Method: 326 subjects treated with EVLT using the 810 nm laser. Results were retrospectively evaluated. Patients were followed-up with Doppler US at 1 and then 3 weeks, and 6 and 12 months post procedure.
Results: Long-term complications were experienced by 11 (3.4%) patients in our subject group whilst re-canalisation occurred in 12 patients. Complete vein recanalisation was not detected.
Conclusion: Based on our experience, crossectomy should be performed, although not routinely, in all patients suffering from varices of the lower limbs. We find the application of over 40 J of energy per centimetre of vein length (J/cm) avoids the possibility of burns. The application of such energy will allow safe occlusion of the vein with minimal risk of recanalisation and burns. Before the operation, we recommend the length of the treated vein be measured in order to deduce the minimum amount of Jules that should be used for a successful occlusion.