Endovascular laser ablation (EVLA) for the treatment of chronic venous insufficiency of the lower extremities can be applied to the perforating veins which connect the superficial and deep venous systems. This retrospective study evaluated outcomes of EVLA using a bare-tip fiber with a 1470 nm laser (with or without additional sclerotherapy or microphlebectomy) of 171 perforating veins in 87 patients with 3 month follow up. Of the 171 perforating veins, 49 had previous GSV disruption on the same extremity, 25 had previous SSV disruption on the same extremity, 88 had previous GSV and SSV disruption on the same extremity, and 9 had patent saphenous veins. On follow up, 94% of perforating veins were occluded at 1 month and 98% were occluded at 3 months. Complete chronic venous insufficiency symptom resolution was found to be 82% and 96% at 1 month and 3 month follow up, respectively. Perforator patency after ablation correlated with higher CEAP scores and the presence of prior GSV/SSV interruption.
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Citation: Chehab, M. et al. Endovenous Laser Ablation of Perforating Veins: Feasibility, Safety, and Occlusion Rate Using a 1,470-nm Laser and Bare-Tip Fiber. Journal of Vascular and Interventional Radiology 26, 871–877 (2015).
Post author: Brian Gardner, MD, Resident in the VIR Pathway, University of Virginia