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
- Local anaesthesia, insertion of the fiber in the saphenous vein through the dedicated introductor.
- The fiber is inserted into the knee until ½ cm from the saphenofemoral junction.
- Anaesthesia for tumescence through the whole vein.
- Laser distribution and fiber retraction of the of the proximal zone to the distal area of the vein.
Results
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
- Mini-invasive procedure.
- Efficient method, safe, delicate.
- Absence of heat damages, thanks to the necessary low energies.
- Minimum postoperative complications compared to the traditional stripping.
- Immediate mobilization of the patient
Treatment of great saphena - Courtesy of C. Baraldi, MD
