Saphenous vein treatment

Treatment of great saphena - Courtesy of C. Baraldi, MD

EUFOTON offers its technology and coherence at the service of phlebology in form of minimally invasive endovenous laser procedures, which can replace or be associated with the conventional venous surgery thus making the post-surgery course shorter and less painful in nearly all cases.
What are the reasons to choose the endovenous laser? Because the endolaser is globally recognized as the most efficient procedure for treating the incontinence of the great saphenous vein (GVS) and the small saphenous vein (SSV).
Lower limbs chronic venous disease (CVD) represents a common pathological condition, affecting approximately 25% of women and 15% of men. Moreover, the high recurrence rate and the risk of evolving toward chronic ulcers impacts severely the national health system. A progressive shift toward a phlebology office-based setting is needed more than ever, both for the mini-invasiveness and for economic reasons.
The technological performance that can be enjoyed nowadays is the result of more than 20 years of research and innovations. The state of the art technology is represented by the LASEmaR® 1500 that emits at 1470 nm laser and that allows to abandon the need of a standardized LEED, favoring a personalized setting, where specific haemodynamics and patients features are taken into account in every single case. Another fundamental step in endovenous laser performance was the introduction of radial/annular/RING fibers, so combining the high effectiveness of the water chromophore with a homogeneous and extremely precise laser emission, which have dramatically reduced the vessel perforation rates.
Nowadays endovenous laser standards leads to a patient treatment in less than 40 minutes, eventually treating both legs in the same session, with a high pre-intra and post-operative quality of life. Moreover, the high echogenicity of the anular fibers together with the innovative software providing a constant LEED control allows endovenous laser outcomes that are to be considered as excellent in the short term and totally competitive in the mid-long term whenever compared with the other therapeutic options. Further the availability of different fiber size, specifically 600 micron and 400 micron allow to treat not only the GSV but also the SSV and other extrasaphenous districts.
Saphenous vein treatment
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    The current solution of the endovenous laser

    The endovenous laser applied with mainly wavelengths, which are selective on water (diode 1470 nm or 1940 nm) and emitted through radial fibers HF Ring, is a mini-invasive procedure dedicated to the treatment of the venous insufficiency of the saphenous vein (big and small).
    The radial optical fiber HF Ring is injected intravenous. Thanks to the laser radiation, which is working at a low energy and temperature, the venous wall shrinks until the complete obstruction of the vein, avoiding its surgical extraction.
    In comparison to the traditional surgical procedures (e.g.: stripping), the endovascular laser results more delicate, safe and fast to perform.
    At the end of the treatment the patient does not feel any pain or complaint and the treatment does not present any risk of scars, infections and hematomas. Moreover, the recovery is immediate.


    The EUFOTON Technology for the simplification of the setting

    During the procedure the energy per linear centimeter of vein (LEED – Linear Endovenous Energy Density) is controlled on the screen of the laser and it is acoustically signaled to the operator. The software of the lasers EUFOTON permits the fast LEED exchange thanks to the different acoustic signals, which can be selected by the surgeon. They permit the correct setting of the LEED according to the features of the single vessel, distributing the endovenous laser energy in a uniform way, avoiding heat damages and burns. Another feature is the pointed roundness of the optical fiber HF Ring, which permits to avoid mechanical damages to the venous wall during the phase of introduction and positioning.

    Positioning under the ultrasound vision

    1. Local anaesthesia, insertion of the fiber in the saphenous vein through the dedicated introductor.
    2. The fiber is inserted into the knee until ½ cm from the saphenofemoral junction.
    3. Anaesthesia for tumescence through the whole vein.
    4. Laser distribution and fiber retraction of the of the proximal zone to the distal area of the vein.


    During the treatment, the flow of energy located on the tip of the fiber crosses the tissue and the heat induced denatures the vein. The effect is an immediate contraction of the vessel and a consequent venous obstruction, which can verify with intraoperative ultrasound. The sound signal, which accompanies the emission of the laser beam, permits to the operator to always determine the correct LEED and therefore the better speed of retraction.

    Advantages for the surgeon

    Endovascular optical fibers HF (High Focus) Ring are realized in order to emit laser beam at 360° radially, permitting a better diffusion of energy and a safer and more homogeneous ablation.
    Other advantages are:
    • Rounded Conical tip for easy access at the intern of the vessel and a simple back up to the femoral saphen junction for positioning
    • Immediate positioning at the junction due to the remarkable ecogenicity
    • Marking is expressed in cm on the fibers length at 360° for exact energy dosage and pull back speed.
    • Available in 400 μm or 600 μm core diameter according to the tipology of the vessel to treat (saphenous, extrasaphenous, troncular and perforator).
    • High quality material allows to reduce energy and improve transillumination of aiming beam during the ablation.
    • Marking expressed in centimeters over the entire length of the fibers at 360 ° to precisely adjust the dosage LEED laser energy during retraction.
    • Radial emission ring developed by optimizing beam angle to maximize the relationship: more fluence = less LEED = less pain.

    Advantages for the patient

    1. Mini-invasive procedure.
    2. Efficient method, safe, delicate.
    3. Absence of heat damages, thanks to the necessary low energies.
    4. Minimum postoperative complications compared to the traditional stripping.
    5. Immediate mobilization of the patient
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