Total Endovenous Laser Ablation of Varicose Veins with 1470 nm and 1940 nm Lasers: A Retrospective Study

Objective. To compare the efficacy and safety of surgical interventions with simultaneous laser ablation of varicose veins with 1470 and 1940 nm lasers. Material and methods. A retrospective study included 100 patients who underwent simultaneous endovenous laser ablation (EVLA) of the great saphenous vein and tributaries (total EVLA) with 1470 nm and 1940 nm lasers. Both groups (1470 nm and 1940 nm group) included 50 patients each. All technical features of total EVLA (catheters and light guides, logistic sequences of catheter installation) were identical in all patients of both groups. In the 1940 nm group, laser exposure power for the great saphenous vein was 5 W at linear energy density (LED) of 50 J/cm (automatic traction 1 mm/s). Linear energy density for dilated tributaries was 25—50 J/cm (manual traction 1—2 mm/s depending on baseline diameter of veins). In the 1470 nm group, similar indicators were 6—8 (automatic traction 1 mm/s) and 6—7 W (manual traction 1—2 mm/s), LED 30—70 J/cm. The endpoints were complications in immediate postoperative period after ablation of dilated tributaries (burns, phlebitis, feeling of «string» or «tension» of skin, paresthesia, hyperpigmentation) and incidence of obliteration of the great saphenous vein and tributaries after 2 days, 1 and 6 months. Results. Both groups were comparable by gender, age, CEAP class, duration of varicose disease and localization of lesion. Signs of tributary phlebitis (induration, soreness, redness) were detected in 6 (12%) patients who underwent intervention with 1470 nm laser and 8 (16%) patients in the 1940 nm group (p=0.774). In postoperative period, 23 (46%) and 29 (58%) patients took painkillers in both groups, respectively (p=0.317). Hyperpigmentation occurred only in the area of obliterated tributaries with straight course. There were no changes in color of skin over typical grape-like varices. Incidence of side effects was similar. Technical results of interventions were identical. Additional obliteration of tributaries after 6—12 months was performed in 5 (10%) and 4 (8%) patients, respectively (p=1.0). Conclusion. Total EVLA with simultaneous ablation of the great saphenous vein and varicose tributaries with 1470 nm and 1940 nm lasers is equally effective and safe.