1. (RESULTS OF PROSPECTIVE NONCOMPARATIVE STUDY)
The education department of surgery of the South Urals Medical University, Chelyabinsk, Russia
The clinic of phlebology and laser surgery “Vasculab” Ltd., Chelyabinsk, Russia
Professor Fokin A.A., Borsuk D.A.
ENDOVENOUS LASER ABLATION OF THE SAPHENOUS VEINS MORE THAN 2 CM OF THE DIAMETER
(RESULTS OF PROSPECTIVE NONCOMPARATIVE STUDY)
30th ACP Annual Congress
November 3-6, 2016
Anaheim, CA, USA 1 1

2. Clinical Practice Guidelines – Management of CVD
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3. Clinical Practice Guidelines – Management of CVD
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4. Clinical Practice Guidelines – Management of CVD
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5. The literature is considered a large diameter greater than 1 cm
Chaar C.I., Hirsch S.A., Cwenar M.T., et al. Expanding the role of endovenous laser therapy: results in large diameter saphenous, small saphenous, and anterior accessory veins. Ann Vasc Surg Jul; 25 (5):
Florescu C., Curry G., Buckenham T. Role of endovenous laser therapy in large and very large diameter great saphenous veins. ANZ J Surg Jul; 86(7-8):
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6. Laser Wavelength Hemoglobin- and Water-specific
H-lasers 810 nm nm
W-lasers nm nm nm
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7. Bare Fiber
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8. Radial Fiber
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9. 2-ring Radial Fiber
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10. Aim
The aim of this study was to investigate the results of endovenous laser ablations (EVLA) of the saphenous veins more than 2 cm of the diameter
Technical result: occlusion of the treated vein
Hemodynamic result: presence or absence of reflux 1 2

11. Material and Methods GSV SSV AASV EVLA
Prospective noncomparative study
Includes 87 patients
Operated from November 2014 until May 2016
91 EVLA
Wavelength 1470 nm
Power 6-10 W
LEED 83,3-164 J/cm
The diameter of the veins close to sapheno- femoral junction was from 21 to 43 mm (mean 28±4,5 mm)
The observation period was from 71 to 450 days (mean 157±47 days)
EVLA
GSV
SSV
AASV
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12. Results 91 EVLA Early follow-up period Occlusion in 87 (95,6%) cases
2nd postoperative day
7th postoperative day
91 EVLA
Occlusion of the vein in 84 (92,3%) cases
In 7 (7,7%) cases the rest lumen was found
Occlusion in 87 (95,6%) cases
In 4 (4,4%) cases the rest lumen was found
In 4 (4,4%) cases we performed ultrasound-guided foam-form sclerotherapy
The education department of surgery of the South Urals Medical University, Chelyabinsk, Russia

13. Results Middle-term follow-up
Over the period of 3-6 months the small stumps of GSV (mean 21 mm ± 5 mm) were found of 3 (3,3%) patients. In all cases it wasn’t reflux in this stumps.
Also only in 1 (1,1%) case we found recanalization with pathological reflux. This patient was treated by UGST. There was no necessary to retreat patients by EVLA.
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14. The position of the fiber in the vein after tumescence
Formation of "blind pocket"
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15. Clinical case Position of the fiber in the middle
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16. Clinical case The "Blind pocket"
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17. Clinical case Residual lumen the next day after the intervention
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18. Clinical case After 1 week there is no blood flow
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19. Clinical case The vein is more than 42 mm of the diameter
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20. Clinical case 26 days after EVLA the vein is 30 mm of the diameter
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21. In 1 (1,1%) case UGST has been done.
Conclusions 1 2
EVLA 1470 nm by radial fibers are really effective also for the veins of the diameter more than 2 cm. We have found occlusion of GSV of 98,9% cases in the middle-term follow-up period.
In 1 (1,1%) case UGST has been done.
This direction is demanded more significant investigation with comparing with open surgery and evaluation of QOL and severity of pain syndrome
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22. Thank you for attention? ? ?
Any questions?
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