Abstract
Objective: Major side effects after endovenous laser ablation (EVLA) are pain and bruising. The aim of this study was to compare outcome and side effects after EVLA for primary varicose veins with 1470 nm diode laser using bare-tip or radial fiber. Methods: From October 2007 to December 2010, 385 patients (453 limbs) with primary varicose veins treated with 1470 nm laser were studied. Bare-tip fiber was used in 215 patients (242 limbs) (BF group) and radial fiber (ELVESTM Radial, Biolitec AG, Germany) was used in 177 patients (211 limbs) (RF group). This study is retrospective study and radial fiber was started for use from November 2008. Laser energy was administered at 6–12 W of power in BF group and 10 W of power in RF group with constant pullback of laser fiber under tumescent local anesthesia. The patients were assessed by clinical examination and venous duplex ultrasonography at 24–48 hours, one week, one month, 4 months and one year follow-up postoperatively. Results: Mean operating time, length of treated vein and linear endovenous laser energy of all cases were 42.6 minutes, 36.2 cm and 83.4 J/cm, respectively. Major complications such as deep vein thrombosis and skin burns were not seen. Bruising (1.9% vs. 19.4%) and pain (0.9% vs. 7.4%) were significantly lower in the RF group. Cumulative occlusion rates by Kaplan-Meier method were 100% at 32 months in RF group and 99.5% at 4 years in BF group. Conclusion: EVLA using 1470 nm laser with the radial fiber minimized adverse effects compared with bare-tip laser fiber.
