Histopathologic Studies of the Below‐the‐Knee Great Saphenous Vein after Endovenous Laser Ablation

BACKGROUND There has been hesitation to use endovenous laser ablation (EVLA) for the treatment of incompetence of the below‐the‐knee great saphenous vein (GSV). OBJECTIVE To assess early pathologic changes in the below‐the‐knee nonvaricose GSV and adjacent tissue after EVLA in legs scheduled for bel...

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Bibliographic Details
Published in:Dermatologic surgery 2009-12, Vol.35 (12), p.1985-1988
Main Authors: Der KINDEREN, DAAN J., DISSELHOFF, BEN C. V. M., KOTEN, JAN WILLEM, De BRUIN, PETER. C., SELDENRIJK, CEES A., MOLL, FRANS L.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Amputation
Atherosclerosis - surgery
Female
Gangrene
Humans
Laser Therapy
Lower Extremity - pathology
Lower Extremity - surgery
Male
Saphenous Vein - pathology
Saphenous Vein - surgery
Venous Insufficiency - surgery
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Summary:BACKGROUND There has been hesitation to use endovenous laser ablation (EVLA) for the treatment of incompetence of the below‐the‐knee great saphenous vein (GSV). OBJECTIVE To assess early pathologic changes in the below‐the‐knee nonvaricose GSV and adjacent tissue after EVLA in legs scheduled for below‐the‐knee amputation. METHODS The below‐the‐knee GSV in five patients was exposed to EVLA using 14‐, 12‐, and 10‐watt laser power with continuous or intermittent laser exposure using a 600‐nm core, bare tip fiber. Six segments (3 × 3 cm) of GSV with adjacent tissue were excised, examined histologically, and compared with non‐laser‐exposed parts of the vessel. RESULTS Histologic evaluation revealed thermal damage of the intima and the internal part of the media. At the site of the laser tip, carbonization and necrosis was observed. Vascular perforation with subsequent perivascular bleeding was occasionally (
ISSN:1076-0512
1524-4725
DOI:10.1111/j.1524-4725.2009.01317.x