Endovenous laser ablation of great and small saphenous vein incompetence with a 1470-nm laser and radial fiber

Giorgio Spreafico; Andrea Piccioli; Enrico Bernardi; Enzo Giraldi; Patrizia Pavei; Riccardo Borgoni; Attilio Nosadini; Ugo Baccaglini

doi:10.1016/j.jvsv.2014.04.012

Endovenous laser ablation of great and small saphenous vein incompetence with a 1470-nm laser and radial fiber

J Vasc Surg Venous Lymphat Disord. 2014 Oct;2(4):403-10. doi: 10.1016/j.jvsv.2014.04.012. Epub 2014 Jul 3.

Authors

Giorgio Spreafico¹, Andrea Piccioli², Enrico Bernardi³, Enzo Giraldi², Patrizia Pavei², Riccardo Borgoni⁴, Attilio Nosadini², Ugo Baccaglini²

Affiliations

¹ Multidisciplinary Centre for Day Surgery, University Hospital of Padua, Padua, Italy. Electronic address: giorgio.spreafico@sanita.padova.it.
² Multidisciplinary Centre for Day Surgery, University Hospital of Padua, Padua, Italy.
³ Emergency Department ULSS7, Pieve di Soligo, Italy.
⁴ Department of Statistics, University of Milano-Bicocca, Milan, Italy.

PMID: 26993546
DOI: 10.1016/j.jvsv.2014.04.012

Abstract

Objective: Endovenous laser ablation (EVLA) of great (GSV) and small saphenous vein (SSV) chronic insufficiency with 1470-nm diode laser and radial fiber yields good short-term results. The aim of this study was to assess its efficacy after at least 12 months of follow-up.

Methods: We performed a prospective interventional cohort study in an ambulatory care/day surgery setting. Consecutive patients with chronic, symptomatic GSV or SSV insufficiency were treated by EVLA with a 1470-nm diode laser and a radial fiberoptic. Patients were recruited between 2008 and 2011, and the follow-up was completed in 2012. All patients underwent clinical and echo color Doppler evaluations during follow-up. The primary outcome was the incidence of echo color Doppler-confirmed failures during follow-up. We also investigated potential associations between failures and patients' characteristics, echo color Doppler findings, or surgical features. The secondary outcome was the postoperative pain course.

Results: The planned 12-month follow-up was completed in 372 patients. Echo color Doppler-confirmed failures occurred in 37 (12%) of 310 patients with GSV insufficiency, whereas none of 62 patients with SSV insufficiency experienced a failure. Multiple Cox proportional hazards regression analysis showed a significant association of failures with a Clinical, Etiologic, Anatomic, and Pathologic class C ≥4 and a mean confluence of the superficial inguinal veins diameter ≥9 mm in patients with GSV insufficiency. Postoperative pain course was favorable. More than two thirds of the patients were asymptomatic at 7 days.

Conclusions: EVLA with 1470-nm diode laser and radial fiberoptic is effective for treatment of GSV and especially SSV insufficiency and is well tolerated by the patients.