0000000000654498
AUTHOR
A. Kargl
Subfascial Endoscopic Perforator Surgery With Tumescent Local Anesthesia
background. Subfascial endoscopic perforator surgery (SEPS) has become an established procedure. objective. To evaluate SEPS with tumescent local anesthesia (TLA) using an single-port device originally designed for that purpose. methods. Patients selected for SEPS received subcutaneous infiltration of TLA into the medial aspect of the calf 20 minutes before surgery. Bipolar coagulation and dissection were used to treat incompetent perforators. results. Fifty-one patients with 67 legs of CEAP stages C3–C6 underwent SEPS with TLA. In 40 patients or 53 legs (79.1%) TLA alone allowed successful completion of the SEPS procedure. Five patients with 7 legs (10.4%) required additional intravenous a…
Thermal damage of the inner vein wall during endovenous laser treatment: key role of energy absorption by intravascular blood.
background. Despite the clinical efficacy of endovenous laser treatment (EVLT), its mode of action is incompletely understood. objective. To evaluate the role of intravascular blood for the effective transfer of thermal damage to the vein wall through absorption of laser energy. methods. Laser energy (15 J/pulse, 940 nm) was endovenously administered to explanted greater saphenous vein (GSV) segments filled with blood (n = 5) or normal saline (n = 5) in addition to GSVs under in vivo conditions immediately prior to stripping. Histopathology was performed on serial sections to examine specific patterns of damage. Furthermore, in vitro generation of steam bubbles by different diode lasers (81…
Infrequent early recanalization of greater saphenous vein after endovenous laser treatment
Abstract Objective The frequency of recanalization of the greater saphenous vein (GSV) after endovenous laser treatment (ELT) is unclear. This study was undertaken to establish the incidence of early recanalization after ELT and to study the histopathologic features of reperfused and excised GSV. Methods One hundred nine GSV in 85 consecutive patients with clinical stage C 2-6 E P,S A S,P,D P R disease were treated with ELT. Twelve months of follow-up with duplex scanning at regular intervals was possible in 104 treated veins (95.4%) in 82 patients (96.5%). Recanalized vessels were removed surgically and examined at histopathology. Results ELT-induced occlusion proved permanent at duplex sc…
Endovenous treatment of the greater saphenous vein with a 940-nm diode laser: thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles.
Abstract Purpose: Despite a rapid spread of the technique, very little is known about the laser-tissue interaction in endovenous laser treatment (EVLT). We evaluated EVLT of the incompetent greater saphenous vein (GSV) for efficacy, treatment-related adverse effects, and putative mechanisms of action. Methods: Twenty-six patients with 31 limbs of clinical stages C 2-6 , E P , A S,P , P R with incompetent GSV proven by means of duplex scanning were selected for EVLT in an outpatient setting. A 600-μm fiber was entered into the GSV via an 18-gauge needle below the knee and proceeded to the saphenofemoral junction (SFJ). After infiltration of tumescent local anesthesia, multiple laser pulses o…