Natural History of the Great Saphenous Vein Stump Following Endovenous Laser Therapy

Abstract

Background: Little is known about the ideal residual length of the great saphenous vein (GSV) stump and its potential role in complications such as acute deep venous thrombosis (DVT) and recanalization. This study was designed to learn about the natural history of the residual GSV stump length following endovenous laser treatment. Methods: Prospective data were collected from 50 limbs of 50 patients over an 11-month period. Clinical assessment and duplex ultrasound were performed preoperatively, at 24 hours and at 3 months after the procedure. Results: The residual GSV stump decreased in length from a mean of 15 mm at 24 hours to 13 mm at 3 months after the procedure. None of the patients developed acute DVT or proximal recanalization when the laser tip was positioned 28 mm distal to the saphenofemoral junction. Conclusion: Endovenous laser therapy of the GSV for symptomatic reflux is safe and effective. The residual GSV stump decreased in length over a 3-month period.

Keywords

endovenous laser treatment great saphenous vein stump deep venous thrombosis ultrasound guidance duplex ultrasound surveillance

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References

Gibson K. , Ferris B. , Polissar N. , Neradilek B. , Peper D. Endovenous laser treatment of the short saphenous vein: efficacy and complications . J Vasc Surg. 2006;45: 795-803.

Puggioni A. , Kalra M. , Carmo M. , Mozes G. , Gloviczki P. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg. 2005;42:488-493.

Min RJ , Khilnani N. , Zimmet SE Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 2003;134:991-996.

Kabnick LS Endovenous laser system (980 nm) for the treatment of saphenous vein insufficiency: 7611 limbs. Paper presented at: ACP 19th Annual Conference; 2005; San Francisco, CA.

Mozes G. , Kalra M. , Carmo M. , Swenson L. , Gloviczki P. Extension of saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques. J Vasc Surg. 2005;41:130-135.

Proebstle TM , Gul D. , Lehr HA , Kargl A. , Knop J. Infrequent early recanalization of greater saphenous vein after endovenous laser treatment. J Vasc Surg . 2003;38:511-516.

Labropoulos N. , Tiongson J. , Pryor L. , et al. Definition of venous reflux in lower-extremity veins. J Vasc Surg. 2003;38:793-798.

Kalra M. , Gloviczki P. Fifteen years ago laser was supposed to open arteries, now it is supposed to close veins: what is the reality behind the tool? Perspect Vasc Surg Endovasc Ther. 2006;18:3-8.

Evans J. , Mong R. , Satiani B. The perioperative role of duplex venous scanning in endo-venous laser therapy . J Vasc Ultrasound. 2007;31:37-40.

10.

Ascer E. , Lorensen E. , Pollina RM , Gennaro M. Preliminary results of a nonoperative approach to saphenofemoral junction thrombophlebitis. J Vasc Surg. 1995; 22:616-621.

11.

Chengelis DL , Bendick PJ , Glover JL , Brown OW , Ranval TJ Progression of superficial venous thrombosis to deep venous thrombosis. J Vasc Surg. 1996 ;24:745-749.

12.

Pichot O. , Sessa C. , Chandler J. , Perrin M. Role of duplex imaging in endovenous obliteration for primary venous insufficiency . J Endovasc Ther. 2000;7:451-459.