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KMID : 0980120020010010028
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Annals of Phlebology
2002 Volume.1 No. 1 p.28 ~ p.33
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Endovenous Laser Treatment of the Varicose Veins
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송기훈 / Song KH
이찬우 / 심승주 / 조광조 / 오종영 / 김기호 / Lee CW / Sim SJ / Cho GJ / Oh JY / Kim KH
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Abstract
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Purpose: It is necessary to eliminate the highest point of reflux originating at the saphenofemoral junction (SFJ) and the greater saphenous vein (GSV) to treat the resultant veins. Minimally invasive alternatives in the treatment of varicose veins with the SFJ and GSV in competence have been tried over the years resulting in varying degrees of success depending of the method used. Recently, endovenous laser occlusion using a diode laser has been introduced with initial successful clinical reports. This study was conducted to evaluate the safety and effectiveness of endovenous laser treatment for closing the incompetent GSV at its junction with femoral vein.
Method: Twenty legs (sixteen patients) with reflux at the SFJ into the GSV were treated with 940 nm diode laser energy administered endovenously through a bare-tipped laser fiber (600 ㎛). The parameters were 12~15 W in continuous mode with bursts of laser energy 1~2 seconds in pulse duration. A duplex doppler ultrasound (DDUS) was used to mark the location of the GSV from the knee to the SFJ. Vein access was achieved by stab wound Mueller hook approach or by ultrasound-guided needle puncture. Exact placement of the fiber was determined by direct observation of the aiming beam through the skin or by ultrasound confirmation. Standard ambulatory phlebectomy was performed as needed to remove remaining variosities. Clinical and duplex evaluation was performed at 1 week, and various monthly intervals (1, 3, 6 months) following the initial treatment.
Result: All twenty treated GSV segments were closed following endovenous treatment, as defined by no detectable flow by color duplex evaluation. Side effects were minimal, with one leg showing transient hyperpigmentation, 3 legs with palpable fibrous cord less than one month, and 4 legs showing significant purpura less than 2 weeks.
Conclusion: In this preliminary study, endovenous laser treatment with the use of 940 nm diode laser was shown to be safe and effective to eliminate SFJ incompetence and close the GSV throughout the 6-month follow-up period. Long-term study will be needed.
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