Safen ven yetmezli̇ği̇ tedavi̇si̇nde endovenöz lazer i̇le ablasyon: 980 nm ile 1470 nm dalga boyundaki lazer enerjisinin tedavideki etkinliğinin karşilaştirilmasi

The incidences of lower extremity venous insufficiency and varices are %20-40. It is a critical health problem that breaks down the health quality and sometimes may cause serios complications. Surgical treatment is traditional method for superficial venos insufficiency and varices. Surgical methods have some disadvantages including general and spinal anesthesia, high complication rate and long hospitalization time. EVLA and foam sclerotherapy have become alternative treatment methods of superficial venous insufficiency and varices in last years. The most advantages of EVLA include local anesthesia, less pain, no scar and immediately mobilization. Because of these advantages EVLA became the fist choice treatment procedure for venous insufficiency all around the world. The laser systems used in EVLA treatment have different wavelengths. 810nm, 940nm, 980nm, 1064nm wavelenght laser systems are hemoglobin spesific, 1320nm, 1470nm wavelenght laser system are water spesific. In our study we aimed to investigate correlations of the tecnical succes, postoperative pain scores and complication ratios between the 980nm and 1470nm wavelenght laser systems. We treated 73 patients (84 extremities) who have symptomatic safenous venous insufficieny with EVLA. 47 patients (54 extremities) were treated with 980 nm laser system, 26 patients (30 extremities) were treated with 1470 nm laser system. The patients were controlled at postoperative 1th week and 1th month, and technical success, early complications, pain scores were noted. We find that there were no statistically significant differences between pain scores, complication rates and technical success of two groups. Additionally, there were not any correlation between pain scores, complication rates and mean laser energy amount that given every cm of saphenous vein. If 980 nm wavelenght laser systems will be used 100 J/cm laser energy, or 1470 nm wavelenght laser systems will be used 50 J/cm laser energy are adequate for complete occlusion of saphenous veins. The quality of tumescent anesthesia, and pull back speed of laser fiber are the other important parameters that determines treatment success. EVLA treatment must be done by physicians who have Doppler US experience. So EVLA treatments must be done by interventional radiologists.