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Role of endovenous laser therapy in large and very large diameter great saphenous veins
Author(s) -
Florescu Cosmin,
Curry Greg,
Buckenham Timothy
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12672
Subject(s) - medicine , great saphenous vein , varicose veins , ablation , saphenous veins , centimeter , laser therapy , surgery , vein , laser ablation , nuclear medicine , laser , optics , physics
Abstract Background The literature suggests that endovenous laser is less efficacious in great saphenous veins ( GSVs ) with a diameter of greater than 1 cm. This paper describes the efficacy of endovenous laser therapy ( EVLT ) in ablating GSV with a diameter greater than 1.0 cm. Methods Retrospective review of consecutive patients undergoing GSV EVLT between 15 November 2012 and 25 July 2013 was performed. GSV with a maximum diameter of ≥1.0 cm were defined as large, those with a maximum diameter of ≥2.0 cm were defined as very large. Results A total of 38 ablations were reviewed; two patients had bilateral GSV vein ablations. All underwent a 6‐week post‐procedural duplex. There were 20 ablations on veins >1 cm and 4 ablations on veins ≥2.0 cm. Median GSV length was 21.5 cm (16.5 cm for <1 cm, 24.5 cm for 1–2 cm and 24.5 cm for >2 cm). When correcting for length of vein treated, the energy deposited was stable for all patients at 80 J/cm. Tumescent volumes per centimetre were 3.7 mL/cm for veins <1.0 cm and 4.6 mL/cm for veins >1.0 cm. Successful ablation was achieved in 100% of veins independent of size. Conclusion Ablation rates for large and very large GSV s in our series do not differ from the cohort of patients with GSV < 1.0 cm and from published results for GSV s < 1.0 cm. This supports the use of EVLT for venous insufficiency in the larger diameter GSV typically found in patients on public hospital waiting lists.