Preliminary results of severe venous insufficiency treatment with thermal ablation of the great saphenous vein by endovascular technique with laser diode 980nm developed in Brazil, associated with sclerotherapy with polidocanol. / Resultados preliminares do tratamento de insuficiência venosa grave com termoablação da veia safena magna por técnica endovascular com laser de diodo 980nm desenvolvido no Brasil, associado à escleroterapia com polidocanol.

The endovenous laser ablation (EVLA) of the insufficient saphenous vein has similar results to open conventional surgery, but less morbidity. The echo-guided polidocanol foam sclerotherapy technique has been used for the same purpose. The combined techniques may play a role for more severe diseases, such as those with varicose ulcers. An EVLA device (called VELAS) has been developed in the Optics and Photonics Research Center of USP-São Carlos in agreement with FMB-UNESP. In this study, we present the preliminary results of the VELAS device (MMO 980nm diode) in patients with chronic venous ulcer, associated with echo-guided polidocanol foam sclerotherapy for the treatment of varicosities. Primary outcomes were healing time of the venous ulcer, occlusion of the treated veins and treatment-related adverse events. We included 12 patients with insufficient saphenous vein and chronic venous ulcer. Initially, we treated all of them with thermoablation of the insufficient saphenous vein (VELAS), on an outpatient basis, with local anesthesia. After one week of the procedure, we sclerosed the varicosities with polidocanol foam (Tessari technique). The national VELAS device was easily handled. Total venous occlusion occurred in 83.3% of the patients (in seven days) and the association of the techniques was responsible for a wound healing rate of 83.3%, with no adverse events.

Resultados preliminares do tratamento de insuficiência venosa grave com termoablação da veia safena magna por técnica endovascular com laser de diodo 980nm desenvolvido no Brasil, associado à escleroterapia com polidocanol / Preliminary results of severe venous insufficiency treatment with thermal ablation of the great saphenous vein by endovascular technique with laser diode 980nm developed in Brazil, associated with sclerotherapy with polidocanol

RESUMO A termoablação endovascular das veias safenas insuficientes com laser é descrita como uma técnica menos invasiva, com resultados semelhantes à cirurgia convencional, porém, com efeitos adversos menos frequentes. A técnica de escleroterapia com espuma de polidocanol ecoguiada vem sendo empregada com a mesma finalidade. A combinação de técnicas pode representar uma alternativa para pacientes mais graves, como os portadores de úlcera varicosa. Um equipamento de laser (denominado VELAS) foi desenvolvido no Centro de Pesquisas em Ótica e Fotônica da USP-São Carlos em convênio com a FMB-UNESP para termoablação endoluminal da veia safena insuficiente. Neste estudo apresentamos os resultados preliminares do uso do aparelho de laser VELAS (diodo MMO 980nm) na termoablação endovascular de veias safenas insuficientes, em portadores de úlcera venosa crônica, associado à complementação com espuma de polidocanol para o tratamento de varicosidades, após uma semana. Os desfechos analisados foram o tempo de cicatrização da úlcera venosa, oclusão das veias tratadas e eventos adversos relacionados aos tratamentos. Foram incluídos 12 pacientes portadores de insuficiência de veia safena e úlcera venosa crônica que aceitaram participar do projeto. Todos foram tratados em regime ambulatorial, com anestesia local e termoablação da veia safena insuficiente (VELAS). Após uma semana da cirurgia, as varicosidades foram esclerosadas com polidocanol espuma (técnica de Tessari). O equipamento laser VELAS nacional apresentou fácil manuseio, oclusão venosa total em 83,3% dos pacientes (em sete dias) e a associação das técnicas foi responsável por uma taxa de cicatrização de feridas de 83,3%, sem ocorrência de eventos adversos.

ABSTRACT The endovenous laser ablation (EVLA) of the insufficient saphenous vein has similar results to open conventional surgery, but less morbidity. The echo-guided polidocanol foam sclerotherapy technique has been used for the same purpose. The combined techniques may play a role for more severe diseases, such as those with varicose ulcers. An EVLA device (called VELAS) has been developed in the Optics and Photonics Research Center of USP-São Carlos in agreement with FMB-UNESP. In this study, we present the preliminary results of the VELAS device (MMO 980nm diode) in patients with chronic venous ulcer, associated with echo-guided polidocanol foam sclerotherapy for the treatment of varicosities. Primary outcomes were healing time of the venous ulcer, occlusion of the treated veins and treatment-related adverse events. We included 12 patients with insufficient saphenous vein and chronic venous ulcer. Initially, we treated all of them with thermoablation of the insufficient saphenous vein (VELAS), on an outpatient basis, with local anesthesia. After one week of the procedure, we sclerosed the varicosities with polidocanol foam (Tessari technique). The national VELAS device was easily handled. Total venous occlusion occurred in 83.3% of the patients (in seven days) and the association of the techniques was responsible for a wound healing rate of 83.3%, with no adverse events.