[Endovascular laser ablation with wavelength 1,560 nm for varicose veins]

In 2002 - 2008 more than 1000 patients with lower limb varicose veins were treated with endovenous laser coagulation (EVLC) of subcutaneous and perforating veins in the Therapeutic Rehabilitation Center. Usually we used laser wavelength between 915 and 980 nm; but recently 1,560-nm laser, which physical properties are quite different, was used for 43 patients, including 49 EVLCs for great (GSV) and lesser (LSV) saphenous veins and 15 EVLCs for perforating veins (PV). Interventional technique was similar to previously used. Postoperative period for 1,560-nm laser ablations was characterized by earlier resolution of mild pain syndrome, more than twice less ecchymosis, and pain absence along the coagulated veins. These resulted of obliteration. in the decrease of postcoagulative period severity, thus enabling patients to ambulate earlier. No complications occurred. Ultrasonic picture of 1,560-nm laser coagulation showed uniform wall thickening, intimal induration and circular narrowing of venous lumen. Histological examination of GSV revealed significant thickening of venous wall due to edema and circular shrinkage, focal necrobiosis and caryolysis. Twenty three patients (who underwent total 35 EVLCs for GSV, LSV and PV) were followed up for 4-6.5 months. In all cases treated veins were completely obliterated; no segments with preserved blood flow and pathological refluxes were revealed. In conclusion, EVLC with wavelength that is actively adsorbed by water is characterized by mild postoperative period and higher efficacy of obliteration.