Endovenous laser ablation therapy in children: applications and outcomes
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Published on: March 7, 2011
Premal A Patel1,2,3, Alex M Barnacle4, Sam Stuart4
1Image Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. premalpatel@doctors.org.uk.
Insights
Endovenous laser ablation is a safe and feasible treatment for various pediatric venous conditions, showing good outcomes in children. This minimally invasive procedure offers effective management for conditions like venous malformations and Klippel-Trenaunay syndrome.
Area of Science:
- Vascular Surgery
- Pediatric Interventional Radiology
- Minimally Invasive Procedures
Background:
- Endovenous laser ablation (EVLA) is a standard treatment for adult varicose veins.
- Its application and safety in pediatric patients are less established.
- This study addresses the gap in understanding EVLA for children's venous diseases.
Purpose of the Study:
- To explore the use of EVLA in diverse pediatric venous conditions.
- To demonstrate the feasibility and safety of EVLA in pediatric populations.
- To highlight EVLA as a potential treatment option for children.
Main Methods:
- Retrospective review of EVLA procedures in pediatric patients.
- Data collected from January 2007 to July 2014 across two major pediatric institutions.
- Analysis of patient demographics, diagnoses, procedures, complications, and outcomes.
Main Results:
- 35 pediatric patients (17 males) underwent EVLA on 43 veins; median age 14 years.
- Common diagnoses included venous malformations, Klippel-Trenaunay syndrome, and superficial venous reflux.
- Low complication rate (6%) with successful treatment in 83% of patients.
Conclusions:
- EVLA is technically feasible and safe for treating pediatric venous diseases.
- It offers good clinical outcomes for a range of conditions in children.
- EVLA can be a valuable tool in pediatric vascular management.
Background:
Endovenous laser ablation is well recognized as the first-line treatment for superficial venous reflux with varicose veins in adults. It is not widely reported and is not an established practice in pediatric patients.
Objective:
To illustrate a variety of pediatric venous conditions in which endovenous laser ablation can be utilized and to demonstrate its feasibility and safety in children.
Materials And Methods:
We conducted a retrospective review of endovenous laser ablation procedures performed between January 2007 and July 2014 at two large pediatric institutions.
Results:
We included 35 patients (17 males) who underwent endovenous laser ablation to 43 veins. Median age at first treatment was 14 years (range: 3-18 years). Median weight was 56 kg (range: 19-97 kg). Underlying diagnoses were common venous malformation (15), Klippel-Trenaunay syndrome (8), superficial venous reflux with varicose veins (5), verrucous hemangioma-related phlebectasia (4), venous varix (2) and arteriovenous fistula (1). The most common aim of treatment was to facilitate sclerotherapy. Thirty-four patients had treatment in the lower limbs and one patient in an upper limb. Ten of the veins treated with endovenous laser ablation had an additional procedure performed to close the vein. Complications attributable to endovenous laser ablation occurred in two patients (6%). One patient experienced post-procedural pain and one patient developed a temporary sensory nerve injury. Median clinical follow-up was 13 months (range: 28 days-5.7 years). The aim of the treatment was achieved in 29 of the 35 (83%) patients.
Conclusion:
Endovenous laser ablation is technically feasible and safe in children. It can be used in the management of a range of pediatric venous diseases with good outcomes.
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