One-Year Outcome of Endovenous Micropulsed Laser Ablation for Incompetent Great Saphenous Vein

ObjectivesIn vitro experiment; laser emission with microseconds pulse width prevents thermal blood coagulation because of thermal relaxation. Initial experience of endovenous micropulsed laser ablation (EMPLA) shows acceptable outcome. The aim of this study was to evaluate efficacy and safety of EMPLA after 1-year follow-up.MethodsThe 1320-nm neodymium:yttrium-aluminium-garnet micropulsed laser with bare fiber was used in 89 limbs (89 patients). Power parameters were pulse width of 100 microseconds, peak power of 4000 W, 12 W output, pulse frequency of 30 Hz, and linear endovenous energy density of 120 J/cm by use of an automatic pullback system. Patient demographics are average age of 67 years; female, 63 patients; and average great saphenous vein (GSV), 3 cm distal. The saphenofemoral junction was 9.3 mm. CEAP class was as follows: C2, 26; C3, 45; C4, 15; C5, two; and C6: one. Five tablets of analgesic were prescribed for occasional postoperative pain. Efficacy evaluation included GSV occlusion rate, GSV shrinkage rate 3 cm distal of saphenofemoral junction, and Chronic Venous Insufficiency Questionnaire 2 score at 1, 3, 6, and 12 months. Safety evaluation included endovenous heat-induced thrombosis within 2 days and bruising at 1 week, pain score by visual analog scale (0-100) at 1 week and 1 month, average number of analgesic tablets taken, and analgesic-free rate.Results(1) Procedure: Average linear endovenous energy density was 122.7 J/cm. Total energy of 3028 J and total pulse number of 7378 were applied. (2) Efficacy evaluation: GSV occlusion rate was 100% until 12 months. GSV shrinkage rate was 39%, 52%, 66%, and 66%, and inner lumen was invisible compressed by thick vein wall after 3 months. Chronic Venous Insufficiency Questionnaire 2 score was 35.1 preoperatively and 27.7, 27.3, 28.2, 24.5, respectively. (3) Safety evaluation: endovenous heat-induced thrombosis (class 1-4) was 0%, and bruising appearance rate was 2.2% (two patients). Average visual analog scale score was 2.4 and 0.4. Average analgesic intake was 0.2 tablet, and analgesic-free rate was 97% (86 patients).ConclusionsEMPLA after 1-year follow-up shows acceptable and promising clinical outcome. This micropulsed system could be the next generation of safe and effective endovenous thermal ablation in the near future. ObjectivesIn vitro experiment; laser emission with microseconds pulse width prevents thermal blood coagulation because of thermal relaxation. Initial experience of endovenous micropulsed laser ablation (EMPLA) shows acceptable outcome. The aim of this study was to evaluate efficacy and safety of EMPLA after 1-year follow-up. In vitro experiment; laser emission with microseconds pulse width prevents thermal blood coagulation because of thermal relaxation. Initial experience of endovenous micropulsed laser ablation (EMPLA) shows acceptable outcome. The aim of this study was to evaluate efficacy and safety of EMPLA after 1-year follow-up. MethodsThe 1320-nm neodymium:yttrium-aluminium-garnet micropulsed laser with bare fiber was used in 89 limbs (89 patients). Power parameters were pulse width of 100 microseconds, peak power of 4000 W, 12 W output, pulse frequency of 30 Hz, and linear endovenous energy density of 120 J/cm by use of an automatic pullback system. Patient demographics are average age of 67 years; female, 63 patients; and average great saphenous vein (GSV), 3 cm distal. The saphenofemoral junction was 9.3 mm. CEAP class was as follows: C2, 26; C3, 45; C4, 15; C5, two; and C6: one. Five tablets of analgesic were prescribed for occasional postoperative pain. Efficacy evaluation included GSV occlusion rate, GSV shrinkage rate 3 cm distal of saphenofemoral junction, and Chronic Venous Insufficiency Questionnaire 2 score at 1, 3, 6, and 12 months. Safety evaluation included endovenous heat-induced thrombosis within 2 days and bruising at 1 week, pain score by visual analog scale (0-100) at 1 week and 1 month, average number of analgesic tablets taken, and analgesic-free rate. The 1320-nm neodymium:yttrium-aluminium-garnet micropulsed laser with bare fiber was used in 89 limbs (89 patients). Power parameters were pulse width of 100 microseconds, peak power of 4000 W, 12 W output, pulse frequency of 30 Hz, and linear endovenous energy density of 120 J/cm by use of an automatic pullback system. Patient demographics are average age of 67 years; female, 63 patients; and average great saphenous vein (GSV), 3 cm distal. The saphenofemoral junction was 9.3 mm. CEAP class was as follows: C2, 26; C3, 45; C4, 15; C5, two; and C6: one. Five tablets of analgesic were prescribed for occasional postoperative pain. Efficacy evaluation included GSV occlusion rate, GSV shrinkage rate 3 cm distal of saphenofemoral junction, and Chronic Venous Insufficiency Questionnaire 2 score at 1, 3, 6, and 12 months. Safety evaluation included endovenous heat-induced thrombosis within 2 days and bruising at 1 week, pain score by visual analog scale (0-100) at 1 week and 1 month, average number of analgesic tablets taken, and analgesic-free rate. Results(1) Procedure: Average linear endovenous energy density was 122.7 J/cm. Total energy of 3028 J and total pulse number of 7378 were applied. (2) Efficacy evaluation: GSV occlusion rate was 100% until 12 months. GSV shrinkage rate was 39%, 52%, 66%, and 66%, and inner lumen was invisible compressed by thick vein wall after 3 months. Chronic Venous Insufficiency Questionnaire 2 score was 35.1 preoperatively and 27.7, 27.3, 28.2, 24.5, respectively. (3) Safety evaluation: endovenous heat-induced thrombosis (class 1-4) was 0%, and bruising appearance rate was 2.2% (two patients). Average visual analog scale score was 2.4 and 0.4. Average analgesic intake was 0.2 tablet, and analgesic-free rate was 97% (86 patients). (1) Procedure: Average linear endovenous energy density was 122.7 J/cm. Total energy of 3028 J and total pulse number of 7378 were applied. (2) Efficacy evaluation: GSV occlusion rate was 100% until 12 months. GSV shrinkage rate was 39%, 52%, 66%, and 66%, and inner lumen was invisible compressed by thick vein wall after 3 months. Chronic Venous Insufficiency Questionnaire 2 score was 35.1 preoperatively and 27.7, 27.3, 28.2, 24.5, respectively. (3) Safety evaluation: endovenous heat-induced thrombosis (class 1-4) was 0%, and bruising appearance rate was 2.2% (two patients). Average visual analog scale score was 2.4 and 0.4. Average analgesic intake was 0.2 tablet, and analgesic-free rate was 97% (86 patients). ConclusionsEMPLA after 1-year follow-up shows acceptable and promising clinical outcome. This micropulsed system could be the next generation of safe and effective endovenous thermal ablation in the near future. EMPLA after 1-year follow-up shows acceptable and promising clinical outcome. This micropulsed system could be the next generation of safe and effective endovenous thermal ablation in the near future.