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original article

Incidence of nerve injury after endovenous laser

ablation of incompetent great saphenous veins

JUNICHI UTOH,

Mei Utoh, Yoshiharu Tsukamoto
Kumamoto Vascular Clinic, Kumamoto, Japan

The content of this study was presented at 21st A nerve injury was defined as any neurological abnor-
Annual Meeting of the European Venous Forum mal feelings in the treated leg persisting after 1 month
on 26th June 2021 (Web). after EVLA. Knee joint pain, sciatic neuralgia, and muscle
pains were carefully excluded.
Summary: At 1 year after EVLA, 25 patients who had postope-
Endovenous laser ablation (EVLA) was performed on rative nerve injury were investigated by phone inter-
1,489 patients with great saphenous vein (GSV) insuf- view. They were asked if there were any changes in their
ficiency. Nerve injury occurred in 3.1% of the patients. symptoms. Patients informed the interviewer of their
Incidence of nerve injury was 4 times higher in cases of current pain level by selecting numbers on a range from
ablation length more than 40cm when compared to those “0-5”. Number “5” means “symptom has not changed”.
below 40cm (5.2% vs 1.3%). One year after EVLA, more Number “0” means “symptom completely disappeared”.
than 90% of the patients were relieved from their Results were divided into 3 groups. Number “1 or 2” is
neurological symptoms. a group of “relieved”. There were also patients who
answered “3-5”. These were put into the “no change”
Objectives: group. They were also asked about their quality of life.
Nerve injury is one of the most common complications
after EVLA. The incidence rate is generally reported, Results:
having a wide range of 3-10% in literatures. The most 1 month after EVLA, treated GSV were evaluated by
common cause of the injury is a damage of the saphen- ultrasonography. All GSV were completely obstructed.
ous nerve system. Many of the injuries are transient, but Nerve injury occurred in 47 legs (3.1%). The symptom
some cases are known to be persistent. was sensory nerve disturbance only. Motor nerves were
In the present study, the incidence of nerve injury not damaged. The most common symptom was a sensory
was observed in patients who underwent EVLA of incom- disorder of saphenous nerve area, like a numbness seen
petent GSV. One year after EVLA, changes of the neuro- after sitting with knee bending position for a long time.
logical symptoms were investigated by phone interview. The relationship between ablation length and incidence
of nerve injury is shown in > fig. 1. The longer the ablation
Methods: length, the higher the incidence rate observed.
From January 2017 to December 2019, 1,489 patients
(1,513 legs) underwent EVLA of incompetent GSV in
the Kumamoto Vascular Clinic. The average age was 64.1
years. Male to female ratio was 1:2.5.
biolitec endovenous laser system (wave-length
1470nm) was used with Radial 2ring fibers (diameter
1.85mm). Anesthesia was a combination of tumescent
local anesthesia and intravenous anesthesia. Ablation
power was 9W. Targeting LEED was set at 50-70J/cm, fig. 1 > Ablation length of GSV and incidence rate © Junichi Utoh
depending on the diameter of GSV. of nerve injury

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