Endovenous laser ablation: the role of intraluminal blood.

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

PubMedID: 21524926

Vuylsteke ME, Martinelli T, Van Dorpe J, Roelens J, Mordon S, Fourneau I. Endovenous laser ablation: the role of intraluminal blood. Eur J Vasc Endovasc Surg. 2011;42(1):120-6.
In this histological study, the role of the intraluminal blood during endovenous laser ablation was assessed.

In 12 goats, 24 lateral saphenous veins were treated with a 1500-nm diode laser. Four goats were treated in an anti-Trendelenburg position (group 1). The next four goats were treated in a Trendelenburg position (group 2) and the remaining four goats in the Trendelenburg position with additional injection of tumescent liquid (group 3). Postoperatively, the veins were removed after 1 week and sent for histological examination. We measured the number of perforations. Vein wall necrosis and the perivenous tissue destruction were quantified using a graded scale.

The 'calculated total vein wall destruction' was significantly higher in the third group (81.83%), as compared with groups one (61.25%) (p < 0.001) and two (65.92%) (p < 0.001). All three groups showed a significant difference in the perivenous tissue destruction scale (p < 0.001) with the lowest score occurring in the third group. Vein wall perforations were significantly more frequent in groups one and two as compared with the third group (T-test respectively p < 0.001, p = 0.02).

A higher intraluminal blood volume results in reduced total vein wall destruction. Injection of tumescent liquid prevents the perivenous tissue destruction and minimises the number of perforations.