Does puncture site affect the rate of nerve injuries following endovenous laser ablation of the small saphenous veins?
Eur J Vasc Endovasc Surg
; 41(3): 400-5, 2011 Mar.
Article
em En
| MEDLINE
| ID: mdl-21194988
ABSTRACT
OBJECTIVES:
The small saphenous vein (SSV) lies in close relationship with sural nerve and is at risk of damage during surgery or vein ablation procedures on this vein. The aim of this study was to compare the effect of puncture site for SSV endovenous laser ablation (EVLA) on the rate of post-operative sural nerve injury.DESIGN:
Randomised controlled study. PATIENTS ANDMETHODS:
Sixty patients with isolated SSV varicose veins (68 limbs) were randomised into two groups. All patients were treated with endovenous laser ablation procedures using radial fibres and a 1470 nm diode laser. In Group 1, SSVs were canulated from lateral malleolar part of the SSV. In Group 2, SSVs were canulated in the mid-calf. EVLA procedures were performed by using 12 W energy and 70 J cm⻹ LEED (linear endovenous energy density). Local pain, ecchymosis, induration and paraesthesia in treated regions, vein diameter, treated vein length, tumescent anaesthesia volume, delivered energy were recorded. Follow-up visits were arranged on the 2nd post-operative day, 7th day, 1st, 2nd, 3rd and 6th months.RESULTS:
The mean SSV diameters at sapheno-popliteal junction (SPJ) and calf levels were Group 1 SPJ 6.6 S.D. 1.2 mm, Calf 5.1 S.D. 1.1 mm, and Group 2 SPJ 6.8 S.D. 1.6 mm, Calf 4.9 S.D. 1.3 mm. Adverse events after treatment were 1 patient with induration, 3 with ecchymosis and 6 minimal paraesthesia in Group 1 (malleolar) and 1 local pain, 4 minimal ecchymosis or induration and 1 paraesthesia in Group 2 (mid-calf). In Group 1 in two patients the paraesthesia lasted 2 months and then resolved spontaneously. In the remaining four patients' paraesthesia resolved in less than 1 month without treatment. In Group 2 paraesthesia resolved spontaneously in two weeks. Induration, ecchymosis and local pain also resolved in less than 2 weeks in both groups. There was no recanalisation or reflux in the treated SSV of either group during the follow-up period.CONCLUSION:
Treatment of the SSV by endovenous laser ablation using a 1470 nm laser and a radial fibre is safe and effective. Puncturing the vein at mid-calf level causes less post-operative nerve injury without affecting the recanalisation rates.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veia Safena
/
Nervo Sural
/
Varizes
/
Traumatismos do Sistema Nervoso
/
Terapia a Laser
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
Eur J Vasc Endovasc Surg
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Turquia