Histological difference between pulsed wave laser and continuous wave laser in endovenous laser ablation

Area of Science:

• Vascular Surgery
• Minimally Invasive Procedures
• Laser Technology

Background:

• Endovenous laser ablation (EVLA) is a common treatment for chronic venous insufficiency.
• Continuous wave (CW) lasers can cause adverse effects like vein perforation.
• Pulsed wave (PW) lasers may mitigate these risks by controlling energy delivery.

Purpose of the Study:

• To compare the safety and efficacy of pulsed wave (PW) versus continuous wave (CW) endovenous laser ablation (EVLA).
• To evaluate the incidence of vein perforation and other adverse effects associated with different EVLA modalities.

Main Methods:

• Comparison of CW and PW laser application in ex vivo venous models.
• Assessment of vein wall integrity and presence of clots after laser treatment.
• Evaluation of outcomes at different energy densities for 1470-nm CW laser.

Main Results:

• Continuous wave laser application resulted in fiber tip clots, unlike pulsed wave.
• CW laser use (980-nm and 1470-nm) led to significant rates of vein perforation and ulcers.
• 1320-nm pulsed wave laser ablation showed no instances of perforation or ulcers in treated venous specimens.

Conclusions:

• Pulsed wave endovenous laser ablation is a safer alternative to continuous wave, significantly reducing the risk of vein perforation.
• PW EVLA demonstrates a favorable safety profile compared to CW EVLA for treating saphenous vein insufficiency.