Abstract

OBJECTIVE: Report on long term results of endovenous laser treatment without tumescent anesthesia METHODS: In August of 2008 seven incompetent greater saphenous veins were treated with a maximum 17J/cm with a 1470mm laser via a radial emitting fiber. Subjects mean age 55.5 years (range 26-86), 100% female, Race 100% Caucasian, CEAP classification: (C2) 4, (C5) 3. All laser ablations were performed without perivenous tumescent anesthesia. Power was set at 3 watts (n=3), 2 watts (n=4). Pullback rate was 2mm/sec. The average energy per cm [LEED] was 8.2 J/cm. RESULTS: During the laser procedure pain was rated on a scale of 0-10 average maximum pain rating was 6.8. Closure rates as determined by lack of compressibility and absence of flow in the treated segment were 6/7 (86%) at three days and 6/7 (86%) at one week. At one week average post operative pain was rated at 1 (scale 0-10). At one month 5/7 (71%) of treated veins were closed and at 2 years 2/7 (29%) of treated veins were closed. In June of 2011 after a 3 year follow-up 7/7 (100%) saphenous veins were compressible and 1/7 (14%) were reflux free. CONCLUSION: The primary closure rate is slightly lower than previously reported rates of laser ablation. Using a radial firing 1470mm laser, it was possible to achieve a high rate of initial closure at energy levels that are low enough to be tolerated by patients without tumescent anesthesia and no significant post operative pain. The early closure rate demonstrates proof of concept. Long term closure and eradication of reflux rates are disappointing.