A RETROSPECTIVE STUDY EVALUATED THE SAFETY AND CLINICAL AND ANATOMIC EFFECTIVENESS OF ENDOVENOUS LASER THERAPY (EVLT) AND MICROPHLEBECTOMY IN THE TREATMENT OF VARICOSE VEINS SECONDARY TO SAPHENOUS REFLUX IN IRAQ .

  • FICMS, cardiothoracic and vascular surgeon.
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Introduction: Chronic venous disorders (CVDs) of the lower extremity are common problems , which is commonly the result of reflux in one or more of the saphenous veins and their primary tributaries. Treatment options in patients with saphenous vein incompetence include conservative management or elimination of these incompetent pathways using endovenous techniques or surgery. Method: From Jan 15, 2015, to Jan 15, 2017, 350 EVLT procedures were performed in 350 patients (213 women) with a mean age of 40.8 years (range, 18-75 years). A 1470-nm diode laser(venacure laser device ,Angiodynamics) and microphlebectomy were used. All sites of superficial axial reflux above and below the knee were ablated. Symptoms of venous insufficiency were present in 97%, and 10 patients (2.85%) had an open ulcer when they underwent operation. Patients had clinical follow-up visits, including duplex ultrasound examination, at 1 week, 1 month, 3 months,6 months and were assessed for deep venous thrombosis (DVT), recanalization of the ablated vein, nerve injury, ulcer healing, and resolution of symptoms. Results: A total of 310 great saphenous veins (88.57%), 30 small saphenous veins (8.57%), 10 combined great and short saphenous veins (2.8) were ablated by endovenous laser therapy by using venacure laser device (1470),Angiodynamics. An average of 280 combined micro phlebectomies(80%) were performed per case treated . The primary ablation rate at 1 and 6 months was 98.2% . Recanalization occurred in 3 veins (0.85%); in this group 2 were successfully closed with a second EVLT.. Postoperatively, the 9 ulcers showed healing at a mean of 5.2 weeks (range, 2-10 weeks), and only 1 failure of healing . No major complicatioens occurred. One DVT (0.28%) occurred, but no pulmonary emboli ,one(0.28%) skin burns had occured. Local transient paresthesia at the ankle and midcalf level occurred in 3 patients (0.85%). Conclusions: EVLT of all sites of superficial axial reflux above and below the knee and microphlebectomy demonstrated that the combined approach is safe and effective at eliminating reflux, affording symptomatic relief, and healing ulcers. It offers the additional advantage of resolving varicose veins and its cause in just one visit, leading to immediate better cosmetic results.

  1. Navarro, L., Min, R.J., and Bone, C. Endovenous laser: a new minimally invasive method of treatment for varicose veins-preliminary observations using an 810 nm diode laser. Dermatol Surg. 2001; 27: 117?122.
  2. Min, R.J., Khilnani, N.M., and Zimmet, S.E. Endovenous laser treatment of saphenous vein reflux: long?term results. J Vasc Interv Radiol. 2003; 14: 991?996
  3. Perkowski, P., Ravi, R., Gowda, R.C., Olsen, D., Ramaiah, V., Rodr?guez-Lopez, J.A. et al. Endovenous laser ablation of the saphenous vein for treatment of venous insufficiency and varicose veins: early results from a large single-center experience. J Endovasc Ther. 2004; 11: 132?138
  4. Proebstle, T.M., Gul, D., and Kargl, A. Endovenous laser treatment of the lesser saphenous vein with a 940-nm Diode Laser: Early results. Dermatol Surg. 2003; 29: 357?361
  5. Gibson, K.D., Ferris, B.L., Polissar, N., Neradilek, B., and Pepper, D. Endovenous laser treatment of the short saphenous vein: Efficacy and complications. J Vasc Surg. 2007; 45: 795?803
  6. Medeiros, C.A.F. and Lucas, G.C. Comparison of endovenous treatment with an 810 nm laser versus conventional stripping of the great saphenous vein in patients with primary varicose veins. Dermatol Surg. 2005; 31: 1685?1694
  7. Mekako, A., Hatfield, J., Bryce, J., Heng, M., Lee, D., McCollum, P.T. et al. Combined endovenous laser therapy and ambulatory phlebectomy: refinement of a new technique. Eur J Endovasc Surg. 2006; 32: 725?729
  8. Sadick, N.S. and Wasser, S. Combined endovascular laser with ambulatory phlebectomy for the treatment of superficial venous incompetence: a 4-year perspective. J Cosmet Laser Ther. 2007; 9: 9?13
  9. 16-Ramelet, A.A. Phlebectomy: technique, indications and complications. Int Angiol. 2002; 21: 45?61
  10. Theivacumar, N., Dellagrammaticas, D., Mavor, A., and Gough, M.J. Clinical significance of persistent below-knee great saphenous vein reflux following endovenous ablation: do we need to modify treatment? (European Venous Forum tripartite meeting abstracts) . Phlebology. 2006; 21: 14
  11. Timperman, P.E. Endovenous laser treatment of incompetent below-knee great saphenous veins. J Vasc Interv Radiol. 2007; 18: 1495?1499
  12. Desmyttere, J., Grard, C., Wassmer, B., and Mordon, S. Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg. 2007; 46: 1242?1247
  13. Timperman, P.E. Prospective evaluation of higher energy great saphenous vein endovenous laser treatment. J Vasc Interv Radiol. 2005; 16: 791?794
  14. Sugerman, H.J. Effects of increased intra-abdominal pressure in severe obesity. Surg Clin North Am. 2001; 81: 1063?1075.

Saadoon H Al Hayazie. (2017); A RETROSPECTIVE STUDY EVALUATED THE SAFETY AND CLINICAL AND ANATOMIC EFFECTIVENESS OF ENDOVENOUS LASER THERAPY (EVLT) AND MICROPHLEBECTOMY IN THE TREATMENT OF VARICOSE VEINS SECONDARY TO SAPHENOUS REFLUX IN IRAQ ., Int. J. of Adv. Res., 5 (11), 1511-1518, ISSN 2320-5407. DOI URL: https://dx.doi.org/10.21474/IJAR01/5928

Dr sadoon H.AlHayazie.dr Bassam Al Alousi
Cardiothoracic and vascular surgeon at al yarmuk teaching hospital

DOI:

Article DOI: 10.21474/IJAR01/5928      
DOI URL: https://dx.doi.org/10.21474/IJAR01/5928

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