Abstract
Objective: Endovenous laser ablation (EVLA) with a 980-nm diode laser has been covered by the Japanese National Health insurance system since 2011. The aim of this study was to demonstrate the early treatment outcomes of EVLA of incompetent great saphenous veins (GSV) with a 980-nm diode laser in an ambulatory setting. Methods: From January to April 2011, 319 patients (354 limbs) with incompetent GSV treated with a 980-nm EVLA were studied. In all patients, laser energy was administered at 8 W to 10 W of power with constant pullback of the laser fiber under tumescent local anesthesia. The patients were assessed postoperatively by clinical examination and venous duplex ultrasonography at 48 hours, 1 week, 1 month and 4 months follow-up. Results: The mean operating time was 34.9 minutes. The mean length of treated veins was 36.3 cm. The mean linear endovenous laser energy (LEED) output was 86.3 J/cm. Major complications such as deep vein thrombosis and skin burns were not observed. There were 136 limbs (38.4%) involving pain and 230 limbs (65.0%) with bruising of the thigh which had all resolved by one-month follow-up. There were 55 limbs (15.5%) with endovenous heat-induced thrombus (EHIT). The cumulative occlusion rate calculated using the Kaplan-Meier method at 7 months was 98.1%. Conclusion: EVLA of the GSV using a 980-nm diode laser is a minimally invasive, safe and efficient treatment as an outpatient procedure and can be considered a standard treatment for primary varicose veins. It is essential for vascular surgeons to learn EVLA using this method.
