INNOVATIONS IN THE ENDOVENOUS LASER ABLATION (EVLA) IN CHRONIC VENOUS DISEASE
The material used for the EVLA has evolved over the years from the original that consisted of an 800 nm laser diode and 600 micron flat tip optical fibre, to lasers with increasingly greater wavelength (940 nm, 980 nm, 1320 nm, 1470 nm, 1550 nm) and optical fibres with protected tip (jacket fibre) or with bare fibres with a hollow tube, self-expandable blades at its distal end around the fibres (tulip fibres) to avoid contact with the vein wall; or even better with radial emission fibres (radial fibre) to circumferentially optimise the contact between the laser light and the venous wall. The current gold standard is a 1470 nm laser diode and radial fibre, recently also available with double emission fibre. The two radial rings of this fibre distanced at 6 mm from one another allow a lower density of thermal energy to be distributed with more homogeneous diffusion along the vessel, with obvious benefits of action on the venous wall and the reduction of unpleasant sensations in the patient.
The literature available for these specific materials is gradually increasing, and new publications are expected.
- Agus GB, Allegra C, Antignani PL, Arpaia G, Bianchini G et Al. Guidelines for the Diagnosis and Therapy of Diseases of the Veins and Lymphatic Disorders. Evidence-based report by the Italian College of Phlebology. Revision 2005. Int Angiol 2005; 24: 107-68.
- Agus GB, Mancini S, Magi G for the IEWG. The first 1000 cases of Italian Endovenous-laser Working Group (IEWG). Rationale, and long-term outcomes for the 1999-2003 period. Int Angiol 2006; 25: 209-15.
- Magi G, Agus GB Antonelli P, Nardoianni V, Sereni O, Bavera PM. Long-term results of endovenous laser treatment of saphenous and perforators reflux in cases of venous leg ulcers. Acta Phlebol 2009; 10: 17-22.- Agus GB, Cecchetti W, Magi G Temperature measurements to improve endolaser vein system treatments with 980 and 1470nm diode lasers. Int Angiol 2010; 29, Suppl 2 to No 2: 27-8.
Agus GB, Cecchetti W, Magi G Temperature measurements to improve endolaser vein system treatments with 980 and 1470nm diode lasers. Int Angiol 2010; 29, Suppl 2 to No 2: 27-8.