Ann Phlebology.  2024 Jun;22(1):27-31. 10.37923/phle.2024.22.1.27.

Early Midterm Results of Laser Assisted Sclerotherapy

• Jun JW
• Jang JR
• Bak YB
• Byun SJ

• KMID: 2557809
• DOI: http://doi.org/10.37923/phle.2024.22.1.27

Abstract

Objective
This study aims to evaluate the effect of treatment for great saphenous vein incompetence with a fourth-generation 1940 nm laser with radial fiber and catheter directed foam sclerotherapy (CDFS) without a tumescent simultaneously. The procedure was termed laser assisted sclerotherapy (LAST). It is a kind of thermochemical ablation.
Methods
From January 1 to June 30, 2023, 86 GSV cases from 50 patients who underwent LAST at Cheongmac hospital were enrolled in this retrospective study. Endogenous laser ablation (EVLA) was performed in the order of accessary vein, tributaries and truncal vein and then followed by CDFS which was performed with a 3% sodium tetradecyl sulfate (STS) mixed with CO 2 gas at a ratio of 1:4. The degree of pain was measured after procedure at 2 hours after the procedure. Follow-up was conducted at 1 week, 1 month, and 6 months.
Results
Three of the 86 GSV observed for >6 months showed mild reflux. According to size and number of ablated vessels, various energy level was needed. Three percent STS was used 4.5±0.4 cc and operation time per GSV was about 8±2 minutes. The VAS score was 2.5±0.6 at 2 hours after surgery. The closure rate was 100% at 6 months. Symptoms improved after 6 months in all patients (6.2±1.2 to 0.9±0.2).
Conclusion
LAST showed a good closure rate in the early midterm follow up period. Ablation was possible with less energy compared with EVLA and the pain index was lower at the second hour after procedure.

Keyword

Laser ablation; Sclerotherapy; Varicose vein