Page 27 - vascular professional 01_2021_eMagazine

vascular professional | issue 01 · 2021 abstract

Feasibility and safety of flush endovenous laser

ablation of the great saphenous vein up to the

saphenofemoral junction

LUCA SPINEDI, M.D.; HANS STRICKER, M.D.; HAK HONG KEO, M.D.;
DANIEL STAUB, M.D.; HEIKO UTHOFF, M.D.

Abstract course of anticoagulation with rivaroxaban, these EHIT
cases resolved without sequelae. Furthermore, one
Objective: (0.8%) superficial vein thrombosis and one (0.8%) calf vein
The optimal ablation distance from the catheter tip to thrombosis at the site of phlebectomy were observed. abstracts
the common femoral vein during endovenous laser abla- No local groin complication occurred. Flush occlusion
tion (EVLA) of the great saphenous vein (GSV) is a matter was observed in 94.5%, 95.3%, and 88.2% of the cases
of debate. In this study, we evaluated the feasibility and at day 1, day 10, and week 6, respectively. Multivariate re-
safety of flush ablation (fEVLA) of the GSV. gression analysis revealed no significant association be-
tween flush ablation at day 1 and age, body mass index,
Methods: CEAP class, fiber type, maximum vein diameter, or applied
This single-center, retrospective analysis of prospectively joules per centimeter.
collected data included all consecutive fEVLA interven-
tions of the GSV between September 2017 and October Conclusions:
2018. Interventions were performed with a 1470-nm ra- The results of this study suggest that fEVLA of the GSV
dially emitting fiber. Primary end points were technical using a radial emitting laser is feasible and seems to be
feasibility of fEVLA and endovenous heat-induced throm- safe.
bosis (EHIT) class 2 to class 4. Secondary end points were
procedure-related complications; anatomic success at This work was funded by a grant from the Swiss Society of Phlebology.
week 6; and flush occlusion at day 1, day 10, and week 6. Author conflict of interest: none.
Presented at the Tenth Annual Venous Symposium, New York, NY, April 11-
Results: 13, 2019; and presented the Twentieth Annual Meeting of the European
A total of 135 consecutive intended fEVLA procedures Venous Forum, Zurich, Switzerland, June 27-29, 2019.
Correspondence: Luca Spinedi, MD, Department of Angiology,
were performed in 113 patients (86 female, 27 male). The Ospedale Regionale di Locarno, 6600 Locarno, Switzerland
average body mass index was 24.9 4.3 kg/m2. The Clini- (e-mail: luca.spinedi@eoc.ch).
cal, Etiology, Anatomy, and Pathophysiology (CEAP) clini- The editors and reviewers of this article have no relevant financial relati-
cal class for these patients was C2 in 78 (57.8%), C3 in 48 onships to disclose per the Journal policy that requires reviewers to decline
(35.6%), C4 in 8 (5.9%), and C5 in 1 (0.7%). The GSV dia- review of any manuscript for which they may have a conflict of interest.
meter at the saphenofemoral junction was 9.4 2.7 mm Copyright © 2020 by the Society for Vascular Surgery. Published by
with a maximum of 16 mm. In 126 cases (93.3%), con- Elsevier Inc.
comitant treatment of tributaries with phlebectomy or Published in Journal of Vascular Surgery: Venous and Lymphatic Disorders,
foam sclerotherapy was performed. In 127 cases (94.1%), Volume 8, Issue 6, November 2020, Pages 1006-1013
https://doi.org/10.1016/j.jvsv.2020.01.017
fEVLA was technically feasible; in 8 cases (5.9%), appro-
priate catheter tip placement was not possible. In these Submitted Jan 16, 2020; accepted Jan 30, 2020.
cases, “standard” GSV ablation 10 to 20 mm distal to the
saphenofemoral junction was performed. In the remain-
ing 127 cases, one (0.8%) EHIT class 2 and one (0.8%)
EHIT class 3 developed at day 10. After a 2- to 3-week

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