Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492012000400006
Jornal Vascular Brasileiro
Original Article

Endolaser venoso: estudo série de casos

Venous endolaser: a case series report

Karina Silvestri Bueno; Daiane Tais Schlindwein Albernaz; Luiz Fernando Lima Albernaz; Fernanda Rita Machado Zignani

Downloads: 4
Views: 1391

Resumo

OBJETIVOS: Relatar nossa experiência de 14 meses, comparando o uso do laser 980 nm com fibra axial com o laser 1.470 nm com fibra radial. MÉTODOS: Foram revisados prontuários de 215 pacientes e comparados resultados de utilização do laser diodo 980 nm com fibra axial e laser diodo 1.470 nm com fibra radial, com e sem infiltração intumescente, respectivamente , analisando porcentagem de oclusão das safenas e complicações. RESULTADOS: Foram tratadas 294 pernas de 215 pacientes. Desse total, 141 casos (65,6%) (192 membros) foram submetidos ao tratamento com laser 980, e 74 casos (34,4%) (102 membros), com o 1.470. Houve ablação completa, com fechamento de 100% em 138 (97,9%) casos para o laser 980 e em 73 (98,6%) casos para o 1.470 (p = 0,999). Houve persistência de dor pós-operatória, necessitando analgésicos num período superior a 7 dias, em 4,3% dos pacientes (seis casos) tratados com o laser 980 e em 5,4% (quatro casos) tratados com 1.470 (p = 0,740). Não houve nenhum caso de hipercromia, trombose venosa profunda ou tromboembolismo pulmonar. Parestesias no trajeto da safena ocorreram em 2,17% dos pacientes tratados com o laser 980 e em 4% dos tratados com o 1.470. CONCLUSÃO: Nossa experiência inicial mostra uma boa efetividade quanto ao fechamento das safenas com laser, poucas complicações pós-operatórias, sendo encontrados resultados semelhantes com ambos os tipos de laser.

Palavras-chave

terapia a laser, insuficiência venosa, varizes

Abstract

OBJECTIVE: To report our 14-month experience comparing the use of 980 nm laser with axial fiber with 1,470 nm laser with radial fiber. METHODS: Charts from 215 patients were reviewed in order to compare the results of the use of 980 nm diode laser with axial fiber and 1,470 nm diode laser with radial fiber, with and without intumescent infiltration respectively, analyzing the percentage of saphenous vein occlusion and complications. RESULTS: A total of 294 legs of 215 patients were treated. Among them, 141 cases (65.6%) (192 limbs) underwent treatment with 980 laser, and 74 (34.4%) (102 limbs) with 1,470 laser. There was complete ablation, with 100% closing, in 138 (97.9%) cases for 980 laser and 73 (98.6%) cases for 1,470 laser (p = 0.999). Persistent postoperative pain requiring analgesics for more than 7 days was reported in 4.3% of patients (six cases) treated with laser 980 and in 5.4% (four cases) treated with 1,470 laser (p = 0.740). There were no cases of hyperchromia, deep venous thrombosis or pulmonary thromboembolism. Paresthesias in the pathway of the saphenous vein occurred in 2.17% of the patients treated with 980 laser and in 4% of those treated with 1,470 laser. CONCLUSION: Our initial experience shows good effectiveness in closing saphenous veins with laser and few postoperative complications, with similar results for both types of laser.

Keywords

laser therapy, venous insufficiency, varices

References

Darwood RJ, Gough MJ. Endovenous Laser treatment for uncomplicated varicose veins. Phlebology.. 2009;24 Suppl 1:50-61.

Rasmussen RH, Lawaetz M, Bjoern L, Vennits B, Blemings A, Eklof B. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg.. 2011;98:1079-87.

Jung IM, Min SI, Heo SC, Ahn YJ, Hwang KT, Chung JK. Combined endovenous laser treatment and ambulatory phebectomy for the treatment of saphenous vein incompetence. Phlebology.. 2008;23:172-7.

Pannier F, Rabe E, Rits J, Kadiss A, Maurins U. Endovenous laser ablation of great saphenous veins using a 1470 nm diode laser and the radial fibre-follow-up after six months. Phlebology.. 2011;26:35‑9.

Van den Bos RR, Kockaert MA, Neumann HA, Nijsten T. Technical review of endovenous laser therapy for varicose veins. Eur J Vasc Endovasc Surg.. 2008;35:88-95.

Schwarz T, Von Hodenberg E, Furtwängler C, Rastan A, Zeller T, Neumann FJ. Endovenous laser ablation of varicose veins with the 1470-nm diode laser. J Vasc Surgery.. 2010;51:1474-8.

Pannier F, Rabe E, Maurins U. 1470 nm diode laser for endovenous ablation (EVLA) of incompetent saphenous veins - a prospective randomized pilot study comparing warm and cold tumescence anaesthesia. Vasa.. 2010;39:249-55.

Doganci S, Demirkilic U. Comparison of 980 nm laser and bare-tip fibre with 1470 nm laser and radial fibre in the treatment of great saphenous vein varicosities: a prospective randomised clinical trial. Eur J Vasc Endovasc Surg.. 2010;40:254-9.

Vuylsteke M, De Bo T, Dompe G, Di Crisci D, Abbad C, Mordon S. Endovenous laser treatment: is there a clinical difference between using a 1500 nm and a 980 nm diode laser? A multicenter randomised clinical trial. Int Angiol.. 2011;30:327-34.

Soracco JE, D'Ambola JO. New wavelength for the endovascular treatment of lower limb venous insufficiency. Int Angiol.. 2009;28:281-8.

Luccas GC, Menezes FH, Barel EV, Medeiros AAFM. Varizes dos membros inferiores: Tratamento. Cirurgia Vascular. :1530-50.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddd25290e88259b441da3e9 jvb Articles

J Vasc Bras

Share this page
Page Sections