Continuous-wave (CW) lasers have been commonly used for endovenous laser ablation (EVLA). However, as some undesired side effects such as postoperative pain and bruising occasionally happens, longer laser wavelength and specially-fabricated laser fibers have been developed. On the other hand, the pulsed-wave (PW) laser, which has a heat production control by thermal relaxation, is independently developed for EVLA. This article discusses the implication of PW laser in EVLA from a theoretical point of view and a newly-developed micropulsation (MP) is introduced as a new concept. Since the MP yields adequate blood and vein wall heat degeneration by microseconds laser emission, efficacy and safety are improved compared with CW laser or conventional PW laser. Initial clinical outcome is favorable and promising for painless EVLA using inexpensive bare fiber.
Higher surgical risks of open repair for inflammatory abdominal aortic aneurysm (I-AAA) associated with severe adhesion around the aneurysm have been reported. Recently endovascular aneurysm repair (EVAR) for I-AAA has been advocated. We experienced an I-AAA with increased fluorine-18 fluoro-deoxy-glucose (18F-FDG) uptake in the aneurysm wall, which was revealed by positron emission tomography/computer tomography(PET-CT), and disappeared 6 months after EVAR. The mechanism, by which inflammation of the aneurysm wall was improved, could not be specified, but a reduction of the pressure load on the aneurysm wall by EVAR may have played a role.