Intraluminal fibre-tip centring can improve endovenous laser ablation: a histological study

Area of Science:

• Vascular Surgery
• Minimally Invasive Procedures
• Histopathology

Background:

• Endovenous laser ablation (EVLA) is a common treatment for varicose veins.
• Traditional EVLA using bare laser fibres can lead to complications like vein wall ulceration and perforation.
• A new tulip-shaped catheter aims to improve EVLA safety and efficacy by centering the laser fibre.

Purpose of the Study:

• To evaluate the safety and efficacy of a novel tulip-shaped catheter for EVLA in goat lateral saphenous veins.
• To determine if the catheter prevents direct contact between the laser fibre and the vein wall.
• To assess the impact on vein wall integrity and perivenous tissue damage.

Main Methods:

• Histological study on ten goat lateral saphenous veins treated with a tulip catheter.
• Comparison with ten veins treated using a standard bare laser fibre.
• Veins examined postoperatively at immediate, 10-day, and 3-week intervals for histological assessment.
• Quantification of vessel wall destruction and perivenous tissue damage using a graded scale.

Main Results:

• The tulip catheter successfully prevented vein wall ulceration and perforation.
• More even transmural vein wall necrosis was observed with the tulip catheter (80% circumference) compared to the bare fibre (64%).
• Significantly less perivenous tissue destruction was recorded with the tulip catheter (scale 1.7) versus the bare fibre (3.8).

Conclusions:

• EVLA with the tulip catheter effectively avoids complications associated with bare fibre treatment, such as ulceration and perforation.
• The tulip catheter promotes more uniform vein wall necrosis.
• This technique leads to reduced perivenous tissue damage, indicating improved safety and outcomes.