A review of endothermal laser ablative treatment of incompetent saphenous veins

Summary

Endovenous treatment of incompetent great and small saphenous veins has become firmly established as an alternative to cross-ectomy and stripping operations. Among other thermal and non-thermal procedures, endovenous laser ablation (EVLA) is one of the most frequently used methods. Development of the procedure has continued since its introduction in 1998: the low wavelengths used at first (810 nm) resulted in a high rate of complications (ecchymosis, pain), and over the years systems using longer wavelengths have been developed with increasingly fewer side effects. The effectiveness of the wavelength most frequently used today (1470 nm) has been reported in numerous studies. The most frequent side effects include endovenous heat-induced thrombosis (EHIT), nerve damage and ecchymosis; major complications like lung embolism are reported very rarely.

Zusammenfassung

Die endovenöse Behandlung von Stammveneninsuffizienzen der Vena saphena magna und Vena saphena parva hat sich mittlerweile neben der Krossektomie und Strippingope-ration in den Therapieoptionen fest etabliert. Neben anderen thermischen und nichtthermischen Verfahren ist die endovenöse Laser-ablation (EVLA) eines der am häufigsten angewendeten Methoden. Seit 1998 entwickelt sich das Verfahren zunehmend weiter, die an-fangs angewendeten niedrigeren Wellenlängen, angefangen bei 810 nm, zeigten hohe Komplikationsraten (Ekchymosen, Schmerzen), im weiteren Verlauf wurden Systeme mit höheren Wellenlängen entwickelt, die zunehmend weniger Nebenwirkungen haben. Die Effektivität des aktuell am häufigsten angewendeten 1470 nm-Lasers ist in zahlrei-chen Studien belegt worden. Die häufigsten Nebenwirkungen umfassen das Auftreten einer Hitzeinduzieren Endovenösen Thromboembolie (EHIT), Nervenläsionen und Ekchymosen, Majorkomplikationen wie eine Lungenembolie treten sehr selten auf.

Keywords

Laser ablation - endothermal treatment - incompetent saphenous veins

Schlüsselwörter

Laserablation - endothermale Behandlung - Stammveneninsuffizienz

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