Endovenous laser ablation of great saphenous vein for the treatment of lower extremity: Two years experience
Turkiye Klinikleri Cardiovascular Sciences
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Objective: Chronic venous insufficiency and varicose veins are very common in the society, and in some clinical cases can lead to serious complications. Especially in the lower extremity superficial venous insufficiency depends more frequently on vena saphena magna, less frequently depending on the vena saphena parva. In the treatment of venous insufficiency, surgical methods was applied previously but nowadays endovenous laser (EVLA) and radiofrequency (RFA) methods are used. Material and Methods: In our study, a total of 207 patients with 220 extremity saphenous veins treated with EVLA [Radial-Emitting Fiber (REF) Advanced Fiber Tools, Germany)] procedure. The entire procedure was performed under doppler ultrasound (General Electric Logiq 500 pro, USA) guided with combination of spinal anestesia and tumescent local anesthesia (Nouvag Dispenser DP20, Switzerland). Before the procedure, all patients the clinical severity, etiology, anatomy, pathophysiology (CEAP) were classified according to the classification. Results: EVLA application of the 220 extremities, all (100%) pathophysiology, was determined depending on reflux. The preoperative diameter of the VSM at the knee level was between 3.8 mm and 6.2 mm (mean 4.6±1.8), while in saphenofemoral junction was found to be between 5.2 mm and 12.4 mm (mean 8.6±2.2). Postoperative diameter of the VSM, especially in the 3rd month of the knee level diameter was 1.7 mm to 3.9 mm (mean 2.2±0.8 p<0.05), in saphenofemoral junction between 2.3 mm to 4.8 mm (mean 3.9±1.8 p<0.05) was changed. As a result of the six-month follow-up of 216 patients (98.6%) showed complete occlusion. There were no major complications was detected but minor complications as cellulite in 6 patients, thrombophlebitis in 8 patients, hematoma in 4 patients and 10 patients paresthesia at knee level demonstrated. Conclusion: EVLA treatment can be performed safely with early mobilization, less pain and lower morbidity rates. Copyright © 2014 by Türkiye Klinikleri.
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