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Laser Treatment for Varicose Veins May Be Superior to Surgical Stripping: Presented at SIR
By Peggy Peck
SALT LAKE CITY, UT -- April 1, 2003 -- Endovenous laser treatment of saphenous vein reflux maintains good long-term closure, according to results reported here March 29th at the 28th Annual Scientific Meeting of the Society of Interventional Radiology.
Two-year follow-up results from a series of 499 veins treated with the diode laser found a closure rate of 93%. "Thus, the recurrence rate was 7%, which is significantly less than the 10% to 25% recurrence rate associated with surgical treatment," said Robert Min, MD, of Weill Medical College of Cornell University. He said these findings suggest that endovenous laser treatment is "at least as good as the prior gold standard of surgical stripping."
Min said that the treatment requires only local anesthesia, so it can be done in an office setting as an outpatient procedure. "The key to success is careful duplex ultrasound assessment of the vein to confirm diagnosis," he said.
The treatment is performed with a 810 mm diode laser (Diomed, Inc., Andover, MA), which is threaded into the greater saphenous vein via a 600 micron laser fiber. Veins are assessed percutaneously under ultrasound guidance. Patients are evaluated clinically with duplex ultrasound at one week and then at one, 6, 12 and 24 months.
Min said he has had no instances of perforation or laser-associated damage with the procedure, which he suggests is due to the "careful ultrasound guidance. We don't fire the laser until we are sure that we have reached the target area, and we fire as we are backing out of the vein."
Patients are able to walk immediately after the procedure, and most patients return to work within days. Unlike surgery, there are no scars with this approach, which causes only minor bruising and pain that can be treated with over-the-counter analgesics, Min said. About 50 U.S. centers are currently offering the procedure, and he expects that number to double by year's end.
The study was funded by Diomed, Inc.
[Endovenous Laser Treatment of Saphenous Vein Reflux: Two Year Follow-Up Results. RJ Min. Abstract: 98]
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