Retained laser fibre: insights and management

Abstract

Objectives: To describe a case of retained endovenous laser fibre. To review the literature and Food and Drug Administration device failure reports. To suggest protocols for avoiding this complication and a method of removal.

Methods: A case of retained fibre removal is described. Fibre removal techniques in vivo and ex vivo in a bovine model on the laboratory bench are presented.

Results: Successful in vivo and ex vivo fibre removal was performed using duplex ultrasound scan guided phlebectomy techniques. Unexplained measured fibre-length discrepancies due to misleading manufacturer's packaging was discovered.

Conclusions: Simple ultrasound-guided micro-phlebectomy techniques can be used to remove retained laser fibres in the office environment. Laser fibre length measurements before and after treatment are recommended. Some preventive guidelines are described to avoid, or at least diagnose immediately, this complication, such as the 'Laser Eclipse Sign'.

Keywords: device failure; duplex ultrasound scan (DUS); endovenous laser ablation; retained laser fibre.