Endovenous laser ablation (980 nm) of the small saphenous vein in a series of 147 limbs with a 3-year follow-up

Eur J Vasc Endovasc Surg. 2010 Jan;39(1):99-103. doi: 10.1016/j.ejvs.2009.09.011. Epub 2009 Oct 15.


Aim: This study aims to demonstrate the treatment outcomes of endovenous laser ablation (EVLA) of incompetent small saphenous veins (SSVs) with a 980-nm diode laser.

Materials and methods: Between 1 June 2003 and 30 June 2006, 128 patients (147 limbs) with varicose veins and reflux in the SSV on duplex ultrasound (US) examination were treated with a 980-nm diode laser under US guidance. EVLA was performed using pulsed mode with a power of 10W. The pulse duration (1.5-3 s) was chosen to deliver a linear endovenous energy density (LEED) depending on the SSV diameter measured 1.5 cm below the sapheno-popliteal junction (SPJ) with the patient standing. For SSV diameters between 2 and 4.5mm, the LEED applied was 50 Jcm(-1). The LEED was 70 Jcm(-1) for 4.5-7 mm, 90 Jcm(-1) for 7-10mm. Patients were evaluated at 1-week, 1-month, 1-year, 2-year and 3-year follow-up.

Results: The initial technical success rate was 100% in 147 patients. The SSV remained closed in 114 of 117 limbs (97%) after 1 year, all of 61 limbs after 2 years and all of 30 limbs after 3 years. For the three SSVs where re-canalisation was observed, the diameter was greater than 9 mm. Major complications have not been detected and, in particular, there was no deep venous thrombosis (DVT). Ecchymoses were seen in 60% with a median duration of 2 weeks. Temporary paraesthesia (mostly hypoaesthesia) was observed in 40% of treated legs with a median duration of 2 weeks. The maximum duration did not exceed 4 weeks. No skin discolouration, superficial burn, thrombophlebitis or palpable induration was observed.

Conclusion: EVLA of the incompetent SSV with a 980-nm diode laser appears to be an extremely safe technique. After successful treatment, there is a very low rate of re-canalisation of the SSV. Obliteration of the SSV was confirmed at 1-, 2- and 3-year follow-up; this study suggests that this procedure will provide a lasting result.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Head-Down Tilt
  • Humans
  • Laser Therapy / adverse effects
  • Laser Therapy / instrumentation*
  • Lasers, Semiconductor*
  • Male
  • Middle Aged
  • Saphenous Vein / diagnostic imaging
  • Saphenous Vein / surgery*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Ultrasonography, Interventional
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / surgery*
  • Venous Insufficiency / diagnostic imaging
  • Venous Insufficiency / surgery*
  • Young Adult