Endovenous laser ablation : different lasers and delivery techniques

Abstract

Endovenous Laser Ablation (EVLA) has become a popular minimally invasive alternative to stripping in the treatment of saphenous vein reflux. Several wavelengths have been proposed; of which 810, 940 and 980- nm are the most commonly used. Thermal shrinkage of collagenous tissue during EVLA plays a significant role in the early and late results of the treatment. Longer wavelengths (>1000-nm) show greater water absorption than shorter wavelengths and may have some advantages for EVLA due to water molecules in the vein lumen cells. However, the most appropriate wavelength is still the subject of debate. The laser light delivery technique is another criteria that affect the success of EVLA. Bare fiber, which is generally used for medical application, delivers the laser light locally focused to application area. Radial fiber, which is a new technique for laser light delivery, emanates the laser energy homogenously circularly to vessel lumen. The aim of this study is to compare the efficacy of 980 and 1940-nm laser wavelengths in the treatment of varicose veins. In this study, 980 and 1940-nm lasers were used to irradiate stripped human veins. Different power settings (8/10W for 980- nm, 2/3W for 1940-nm) and laser delivery techniques (radial and bare fiber) were used to compare their effects. As a conclusion, 1940-nm TM-fiber laser and radial fiber are promising methods in the treatment of varicose veins.|Keywords : Endovenous Laser Ablation, 1940-nm, 980-nm, Radial Fiber, Bare Fiber, Varicose Vein.