Endovascular laser treatment of varicose vein: a three years personal experience

Endovenous Laser Treatment of the GSV seems to offer a safer alternatìve to traditional surgery (ligation and stripping). Early and mid term results of Endovenous Laser Treatment of incompetent greater and lesser saphenous veins have been promising. This minimally invasive technique appears to be and a 600 pm laser fiber (Bioliteco) was inserted at the end of the 5-F intoducer sheath. The sheath was then withdrawn up to a site mark indicating the last 2 cm of the laser fibre. The correct position of the fibre tip was confirmed by direct visualization of the red transluminant líght beam of the laser fibre through the skin. Tumescent local anesthesia (45 ml of 0.25 % Mepivacaine hydrochloride, neutralized with sodium bicarbonate) was delivered along the perivenous space under sonographic guidance in order to avoid accidental puncture of the vein. In order to obtain a non-thrombotic occlusion of the vein, laser energy was delìvered at 810 nm wavelength in 11 0 patients and at 980nm in 46 patients, using a 600 pm laser fìbre. Instrument setíìngs were: power 12W, pulse duration 1 sec, interval between pulses 1 sec. Rio, October 2" to 7", 2005 a Dimitrios J. Kontothanassis safe, easy to períorm, well tolerated, with lower rates of complication and the avoidance of general or epidural anaesthesia. Continued evaluation with a larger numbers of patients and longer-term follow-up are needed to further define the role of endovenous techniques as treatment alternatives in patients with cronic vein insufficiency.