Endovenous laser treatment of the lesser saphenous vein with a 940-nm diode laser:: Early results

BACKGROUND. Until now, endovenous laser treatment (ELT) of the lesser saphenous vein (LSV) has not been reported. OBJECTIVE. To evaluate efficacy and side effects for ELT of the LSV. METHODS. Otherwise unselected patients with an incompetent LSV were included. After perivenous infiltration of tumescent local anesthesia, laser energy (940 nm) was administered endovenously, either in a pulsed fashion or continuously during constant backpull of the laser fiber. Patients were scheduled for duplex follow-up at Day 1 and also at 1, 3, 6 and 12 months, postoperatively. RESULTS. Forty-one LSVs were targeted in 33 patients with a median age of 66 years (range, 35 to 93). Seventy-three percent of patients had skin changes (C4). Thirty-six percent had an open or healed venous ulcer (C5,6) and 15% a postthrombotic syndrome (E-S A(S,D) P-R ). Thirty-nine LSVs (95%) completed ELT successfully. During a median follow-up interval of 6 months (range, 3 to 12 months), no recanalization event could be observed. Apart from one thrombosis of the popliteal vein in a patient with polycythemia vera, only minor side effects, particularly no permanent paresthesia, could be observed. CONCLUSION. ELT of the LSV under tumescent local anesthesia is feasible and effective. Caution is warranted with ELT of thrombophilic patients.