Skip to main content

Laser Treatment of the Venous System

  • Chapter

Abstract

Venous disease affects millions of people worldwide, and laser technology has revolutionized venous therapies. Surface venous lesions, superficial veins, and deep veins now have treatment options available which have completely replaced older open surgical procedures. A knowledge of laser-tissue interaction is necessary to successfully treat venous pathology in a safe and predictable manner. Laser safety demands special precautions for both the patient and the medical personnel. Treatment options usually are designed around the abnormal anatomic and physiologic findings on duplex ultrasound for non-cutaneous lesions; a good understanding of venous anatomy for both cutaneous and non-cutaneous lesions is essential. Surface laser application is effective for lesions with small vessels (cutaneous lesions) and endovenous laser is used for intraluminal obliteration of refluxing (insufficient) veins, and can be used for lysis of thrombotic lesions of the deep venous system. This versatile technology will predictably continue to improve venous therapy outcomes as it is further refined in the future.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Goldman M, Guex J, Weiss R. Sclerotherapy: treatment of varicose and telangiectatic leg veins. 5th ed. London: Saunders Elsevier; 2011.

    Google Scholar 

  2. Gloviczki P, editor. Handbook of venous disorders: guidelines of the American Venous Forum. 3rd ed. London: Hodder Arnold; 2009.

    Google Scholar 

  3. Adamic M, Troilius A, et al. Vascular lasers and IPLS: guidelines for care from the European Society for Laser Dermatology (ESLD). Cosmet Laser Ther. 2007;9(2):113–24.

    Article  Google Scholar 

  4. Ross E, Domankevitz Y. Laser treatment of leg veins: physical mechanisms and theoretical considerations. Laser Surg Med. 2005;36:105–16.

    Article  Google Scholar 

  5. Goldman MP, Amiry S. Closure of the greater saphenous vein with endoluminal radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: 50 patients with more than 6-month follow-up. Dermatol Surg. 2002;28:29.

    PubMed  Google Scholar 

  6. Merchant RF, Pichot O, et al. Four-year follow = up on endovascular radiofrequency obliteration of great saphenous reflux. Dermatol Surg. 2006;31:129.

    Article  Google Scholar 

  7. Kabnick LS, Merchant RF. Twelve and twenty-four month follow-up after endovascular obliteration of saphenous vein reflux – a report from the multi-center registry. J Phlebol. 2001;1:17.

    Google Scholar 

  8. Calcagno D, Rossi JA, et al. Effect of saphenous vein diameter on closure rate with Closure FAST radiofrequency catheter. Vasc Endovasc Surg. 2009;43:567.

    Article  Google Scholar 

  9. Parlette E, Groff W, et al. Optimal pulse durations for the treatment of leg telangiectasas with a Neodynium YAG laser. Lasers Surg Med. 2006;38:98–105.

    Article  PubMed  Google Scholar 

  10. Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220:524–7.

    Article  CAS  PubMed  Google Scholar 

  11. Massaki A, Kiripolsky M. Endoluinal laser delivery mode and wavelength effects on varicose veins in an Ex vivo model. Laser Surg Med Spec Issue: Dermatol Plast Surg. 2013;45(2):123–9.

    Article  Google Scholar 

  12. Disselhoff BC, Rem AI, et al. Endovenous laser ablation: an experimental study on the mechanism of action. Phlebology. 2008;23:69.

    Article  CAS  PubMed  Google Scholar 

  13. Fan CM, Rox-Anderson R. Endovenous laser ablation: mechanism of action. Phlebology. 2008;23:206.

    Article  PubMed  Google Scholar 

  14. Doganci S, Demirkilic U. Comparison of 980 nm laser and bare-tip fibre with 1470 nm laser and radial fibre in the treatment of great saphenous varicosities: a prospective randomized clinical trial. Eur J Vasc Surg. 2010;40(2):254–9.

    Article  CAS  Google Scholar 

  15. Pannier F, Rabe E, et al. First results with a new 1470-nm diode laser for endovenous ablation of incompetent saphenous veins. Phlebology. 2009;24(1):26–30.

    Article  CAS  PubMed  Google Scholar 

  16. Samuel N, Wallace M, et al. Comparison of 12-W versus 14-@ endovenous laser ablation in the treatment of great saphenous varicose veins: 5-year outcomes from a randomized controlled trial. Vasc Endovasc Surg. 2013;47(5):346–52.

    Article  Google Scholar 

  17. Baumler W, Ulrich H, et al. Optimal parameters for the treatment of leg veins using Nd:YAG lasers at 1064 nm. Br J Dematol. 2006;155(2):364–71.

    Article  CAS  Google Scholar 

  18. Laser hazards: safety standards. Available from: https://www.osha.gov/SLTC/laserhazards/.

  19. Scherer K, Waner M. Nd:YAG lasers (1,064 nm) in the treatment of venous malformations of the face and neck: challenges and benefits. Lasers Med Sci. 2007;22(2):119–26.

    Article  PubMed  Google Scholar 

  20. Kabnick L, Ombrellino M. Ambulatory phlebectomy. Semin Interv Radiol. 2005;22(3):218–24.

    Article  Google Scholar 

  21. Fitzpatrick TB. “Soleil et peau” [Sun and skin]. J de Médecine Esthétique (in French). 1975;2:33–4.

    Google Scholar 

  22. Pathak MA, Jimbow K, Szabo G, Fitzpatrick TB. Sunlight and melanin pigmentation. In: Smith KC, editor. Photochemical and photobiological reviews. New York: Plenum Press; 1976. p. 211–39.

    Chapter  Google Scholar 

  23. Major A, Brazzini B, et al. Nd:YAG 1064 nm laser in the treatment of facial and leg telangiectasias. J Eur Acad Dermatol Venereol. 2001;15(6):559–65.

    Article  CAS  PubMed  Google Scholar 

  24. Tanghetti E, Sherr E. Treatment of telangiectasia using the multi-pass technique with the extended pulse width, pulsed dye laser. J Cosmetic Laser Ther. 2003;5:71–5.

    Article  Google Scholar 

  25. Navarro L, Min R, et al. Endovenous Laser: a new minimally invasive method of treatment for varicose veins; preliminary observations using an 810 nm diode laser. Dermatol Surg. 2001;27:117–22.

    CAS  PubMed  Google Scholar 

  26. Ombrellino M, Kabnick L. Varicose vein surgery. Semin Interv Radiol. 2005;22(3):185–94.

    Article  Google Scholar 

  27. Rasmussen L, Bjoern M, et al. Randomised clinical trial comparing endovenous laser ablation with stripping of the great saphenous vein: clinical outcome and recurrence after two years. Eur J Vasc Endovasc Surg. 2010;39(5):630–5.

    Article  CAS  PubMed  Google Scholar 

  28. Mozes G, Kalra M, et al. Extension of the saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques. J Vasc Surg. 2005;41(1):130–5.

    Article  PubMed  Google Scholar 

  29. Rhee S, Cantelmo N. Factors influencing the incidence of endovenous heat-induced thrombosis (EHIT). Vasc Endovasc Surg. 2013;47(3):207–12.

    Article  Google Scholar 

  30. Agis H, Kabnick L, et al. Minimization of thermally-induced thrombosis at the saphenofemoral junction during endothermal ablation of the great saphenous vein; safe position for catheter tip placement. Presented at: XVI meeting of the Union Internationale de Phlebologie. 2009.

    Google Scholar 

  31. Den Bos R, Neumann M, et al. Endovenous laser ablation-induced complications: review of the literature and new cases. Dermatol Surg. 2009;35(8):1206–14.

    Article  Google Scholar 

  32. Kabnick L, Ombrellino M, et al. Endovenous heat induced thrombus (EHIT) following endovenous vein obliteration: to treat or not to treat? Presented at: Third International Vein Congress. 2005.

    Google Scholar 

  33. Hingorani A, Ascher E, et al. Deep venous thrombosis after radiofrequency ablation of the great saphenous vein: a word of caution. J Vasc Surg. 2005;41(2):314.

    Article  Google Scholar 

  34. Puggioni A, Kalra M, et al. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg. 2005;42(3):488–93.

    Article  PubMed  Google Scholar 

  35. Dexter D, Kabnick L, et al. Complications of endovenous lasers. Phlebology. 2012;27 Suppl 1:40–5.

    Article  PubMed  Google Scholar 

  36. Yildirim E, Saba T, et al. Treatment of an unusual complication of endovenous laser therapy: multiple small arteriovenous fistulas causing complete recanalization. Cariovasc Interv Radiol. 2009;32:166–8.

    Article  Google Scholar 

  37. Klein J. Tumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction. J Dermatol Surg Oncol. 1990;16:248–63.

    Article  CAS  PubMed  Google Scholar 

  38. Silverstein M, Heit J, et al. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158(6):585–93.

    Article  CAS  PubMed  Google Scholar 

  39. Comerota A, Throm R, et al. Catheter-directed thromboysis for iliofemoral deep vein thrombosis improves health-related quality of life. J Vasc Surg. 2000;32(1):130–7.

    Article  CAS  PubMed  Google Scholar 

  40. Grewal N, Marinez J, et al. Quantity of clot lysed after catheter-directed thrombolysis for iliofemoral deep venous thrombosis correlates with postthrombotic morbidity. J Vasc Surg. 2010;51(5):1209–14.

    Article  PubMed  Google Scholar 

  41. Moritz M, Ombrellino M, Agis H. Excimer laser for debulking and lysing chronic venous thrombi and occlusions. Vasc Endovasc Surg. 2009;43(4):370–4.

    Article  Google Scholar 

  42. Papaioannou T, Sorocoumov O, Taylor K, Grundfest WS, et al. Excimer laser assisted thrombolysis: the effect of fluence, repetition rate and catheter size. In: Bartels KE, editor. Lasers in surgery: advanced characterization, therapeutics, and systems XII, Proceedings of SPIE, Bellingham, USA; vol. 4609. 2002. p. 413–8.

    Google Scholar 

  43. Moritz M, Ombrellino M. Excimer laser as an adjunct for popliteal aneurysm. Endovasc Today. 2007;6:41–2.

    Google Scholar 

  44. Caggiati A, Bergan J, et al. Nomenclature of the veins of the lower limb: extensions, refinements, and clinical application. J Vasc Surg. 2005;41:719–24.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mark W. Moritz MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Moritz, M.W., Ombrellino, M., Agis, H. (2015). Laser Treatment of the Venous System. In: Topaz, O. (eds) Lasers in Cardiovascular Interventions. Springer, London. https://doi.org/10.1007/978-1-4471-5220-0_24

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5220-0_24

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5219-4

  • Online ISBN: 978-1-4471-5220-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics