Dr. Goldman is a consultant and owns stock options in NewStar Lasers.
Version of Record online: 25 FEB 2013
Copyright © 2012 Wiley Periodicals, Inc.
Lasers in Surgery and Medicine
Special Issue: Dermatology and Plastic Surgery
Volume 45, Issue 2, pages 123–129, February 2013
How to Cite
Massaki, A. B.M.N., Kiripolsky, M. G., Detwiler, S. P. and Goldman, M. P. (2013), Endoluminal laser delivery mode and wavelength effects on varicose veins in an Ex vivo model. Lasers Surg. Med., 45: 123–129. doi: 10.1002/lsm.22069
Dr. Kiripolsky and Dr. Massaki received honorarium for research from NewStar Lasers.
- Issue online: 25 FEB 2013
- Version of Record online: 25 FEB 2013
- Manuscript Accepted: 5 AUG 2012
- endoluminal laser;
- endovenous laser ablation;
- varicose veins;
- great saphenous vein
Background and Objectives
Endovenous laser ablation (EVLA) has been shown to be effective for the elimination of saphenous veins and associated reflux. Mechanism is known to be heat related, but precise way in which heat causes vein ablation is not completely known. This study aimed to determine the effects of various endovenous laser wavelengths and delivery modes on ex vivo human vein both macroscopically and microscopically. We also evaluated whether protected-tip fibers, consisting of prototype silica fibers with a metal tube over the distal end, reduced vein wall perforations compared with non-protected-tip fibers.
Materials and Methods
An ex vivo EVLA model with human veins harvested during ambulatory phlebectomy procedures was used. Six laser fiber combinations were tested: 810 nm continuous wave (CW) diode laser with a flat tip fiber, 810 CW diode laser with a protected tip fiber, 1,320 nm pulsed Nd:YAG laser, 1,310 nm CW diode laser, 1,470 nm CW diode laser, and 2,100 nm pulsed Ho:YAG laser.
Perforation or full thickness necrosis of a portion of the vein wall was observed in 5/11 (45%), 0/11 (0%), 3/22 (14%), 7/11 (64%), 4/6 (67%), and 5/10 (50%) of cross-sections of veins treated with the 810 nm CW diode laser with a flat tip fiber, the 810 CW diode laser with a protected tip fiber, the 1,320 nm pulsed Nd:YAG laser, the 1,310 nm CW diode laser, the 1,470 nm CW diode laser, and the 2,100 nm pulsed Ho:YAG laser, respectively.
Our results have shown that the delivery mode, pulsed Nd:YAG versus CW, may be just as important as the wavelength. Therefore, the 1,310 nm CW laser may not be equivalent to the 1,320 nm pulsed laser. In addition, protected 810 nm fibers may be less likely to yield wall perforations than their non-protected counterparts. Lasers Surg. Med. 45: 123–129, 2013. © 2012 Wiley Periodicals, Inc.