Evaluation of Endovenous Laser Ablation Started Near the Sapheno-femoral Junction Using a 1470 nm Diode Laser and Radial 2ring Fiber

Abstract

Objective: After endovenous laser ablation (EVLA) of the great saphenous vein (GSV), the patent branches at the sapheno-femoral junction (SFJ) could be a cause of recurrence of varicose veins. The aim of this study is to evaluate whether the EVLA started near the SFJ with a 1470 nm diode laser and radial 2ring fiber decreases the number of patent branches at the stump of the GSV. Methods: From July 2016 to June 2017, 101 limbs in 78 patients with GSV varicose veins were evaluated. EVLAs were started 6.6±1.3 mm distal to the SFJ. The first follow-up (3–5 days), the second follow-up (8–11 days), and the third follow-up (1 month) were done using ultrasonography. Result: The incidence of EHIT was as follows: class 1, 15.8%; class 2, 13.9%; and class 3, 2.0%. The GSV stumps had 0–3 patent branches. In addition, the percentages of the GSV stumps without a patent branch at the first, second, and third follow-up were 54.5%, 50.5%, and 42.6%, respectively. At the third follow-up, the GSV stump length in all limbs was 7.1±5.8 mm. Furthermore, the GSV stump length without a patent branch was shorter than that with patent branches (2.4±4.0 mm vs. 10.7±4.2 mm; p<0.001). Conclusion: EVLA started near the SFJ with a 1470 nm diode laser and radial 2ring fiber resulted in a short GSV stump without a residual patent branch in about 40% of limbs. This could help decease the recurrence of varicose veins at the SFJ.