Introduction. Endovenous laser coagulation (EVLC) of varicose veins was proposed as a minimally invasive alternative to conventional surgery for varicose disease of the lower limbs. Various strategies were proposed for optimal management. But until now, the safety and effectiveness of different endovenous laser ablation regiments for varicose disease has not been fully evaluated.
Purpose. The objective of this study was to compare efficacy and side effects of endovenous laser coagulation (EVLC) in early postoperative period using an 940-nm, 1470-nm и 445-nm diode lasers.
Materials and Methods. 142 patients, diagnosed with varicose disease of the lower limbs with CEAP classification 2 to 6, were enrolled in this study. We compared three groups of the patients: 1 group – 48 patients, who was treated with an endovenous diode 940-nm laser by pulse regime 50:10 emission at 15 – 18 W, 2 group – 53 patients with an 1470-nm diode laser by continuous emission at 7 to 9 W, 3 group – 41 patients with an 445-nm diode laser by continuous emission at 1,5 to 2 W. Intravascular laser ablation was performed with variable retraction speed. Spinal or local, but not tumescent, anesthesia was used.
A duplex ultrasound examination (combination of the traditional ultrasound with color and spectral Doppler) was performed to evaluate degree of reflux in junction of the common femoral vein with the great saphenous vein, make an assessment of the local haemodynamics, vein wall characteristic ets.
Discussion. Patients were scheduled for duplex sonography follow-up at Day 1 and also at 1, 2, 3 and 4 weeks, postoperatively.
Objective examination was performed at 1 day, 1, 2, 3 and 4 weeks after the procedure. Clinical characteristics include: pain sing, sensitivity disturbances and local postablation inflammation sings (infiltration, hyperaemia, oedema, pain along treated vein). Measurement of pain in the patients in early postoperative period was evaluation with Verbal Descriptor Scale (Gaston - Johansson F., Albert М., Fagan E. et al., 1990).
It was found minimum tissues injury in patients, who was treated by intravascular laser ablation lengthwise 1470 nm и 445 nm, compared an endovenous diode 940-nm laser, that provides with favourable effect on postoperative period.
Key words: Varicose Disease, Endovenous Laser Coagulation, Varicose Veins, Laser Ablation, Postoperative Period, Duplex Ultrasound Examination.
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