RESUMEN
OBJECTIVE: To evaluate treatment of the small saphenous vein (SSV) by endovenous laser ablation. STUDY DESIGN: A cohort study, occlusion of the vein and safety of the procedure was analysed prospectively. PATIENTS: 150 consecutive patients (169 limbs) were treated between August 2006 and January 2008 in an outpatient clinic setting. The average age was 57 years (range 23-87); 82% female; 31% had serious varicose disease (CEAP 3-6). Treated length averaged 23 cm (range 6-53 cm). METHODS: All patients underwent a standardised assessment comprising digital questionnaire, physical examination and duplex ultrasonography. The SSV was cannulated percutaneously under ultrasound control and perivascular local anaesthesia (tumescent) was injected. An 810 nm diode laser was used, delivering 70 J/cm. Three months post-treatment all patients received a duplex ultrasound of the treated vessel. RESULTS: Complete occlusion of the SSV after 3 months was achieved in 98% of the cases. Two patients (1.3%) had sural nerve paraesthesia. Six patients developed superficial thrombophlebitis. Serious complications did not occur. CONCLUSIONS: Endovenous laser ablation for treating the incompetent small saphenous vein is a safe, effective and technically feasible technique.
Asunto(s)
Terapia por Láser , Vena Safena/cirugía , Várices/cirugía , Insuficiencia Venosa/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Anestésicos Locales , Estudios de Factibilidad , Femenino , Humanos , Terapia por Láser/efectos adversos , Masculino , Persona de Mediana Edad , Parestesia/etiología , Estudios Prospectivos , Vena Safena/diagnóstico por imagen , Encuestas y Cuestionarios , Tromboflebitis/etiología , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía Doppler Dúplex , Ultrasonografía Intervencional , Várices/diagnóstico por imagen , Insuficiencia Venosa/diagnóstico por imagen , Adulto JovenRESUMEN
OBJECTIVE: The aim of this study was to investigate the feasibility to measure microcirculatory blood flow changes in patients with venous ulcers, by using the laser speckle imaging. METHODS: Nine patients with a leg ulcer were measured with the laser speckle imager in a sitting position before and after mimicking venous hypertension, with the legs raised, by applying a blood pressure cuff and inflating it to 60 mmHg. RESULTS: The results were inconclusive, due to the fact that a lot of practical problems interfered with the measurements, e.g. movement artefacts and inadequate wound visualisation. CONCLUSION: The additional value of laser speckle imaging in daily practice for wound care still remains an important question for further research. A reliable, reproducible microcirculation measurement in venous ulcers might predict venous ulcer healing and recurrence and therefore would be a valuable diagnostic tool in daily practice.