Damage to Vein Wall and Surrounding Tissues During Endovenous Laser Ablation with 1910 nm

Objective. To evaluate vein wall and surrounding tissue damage during endovenous laser ablation (EVLA) with 1910 nm device and different settings. Material and methods. EVLA was performed in 2 sheep under general anesthesia. We used laser fibers with flat and radial tips, wavelength 1910 nm, power 1.5 W, 3 W and 4 W, laser fiber speed extraction 2 mm/sec. Macroscopic and microscopic assessment of damaged veins and surrounding vessels and nerves was carried out considering the distance between the vein wall and damaged structures. Results. Flat fiber at various powers contributed to eccentric vein wall damage up to perforation at a power of 4 W. Damage to perivascular vessels occurred at a distance of 1511±69.3 µm. Ablation with radial laser fiber damaged the vein wall uniformly. Ablation with 4 W damaged all layers of the vein wall. Thermal damage of perivascular vessels was observed at 457.5±30.6 µm from the vein wall. Conclusion. EVLA with 1910 nm laser and radial fibers makes it possible to reduce power to 3—4 W. This prevents vein wall perforation while all layers are damaged. Surrounding structures are damaged at a lesser distance if radial fiber is used.