Preliminary experience with a 1470 nm diode ring laser with echosclerotherapy in lower limb varicose veins

Objective：To study the effect of endovenous laser ablation (EVLA) of lower limb varicose veins using a 1470 nm diode ring laser with ultrasound-guided foam sclerotherapy (UGFS), also known as echosclerotherapy. Methods：From January 2020 to December 2022, 236 patients with primary lower limb varicose veins were enrolled in the study. All patients were treated with 1470 nm diode ring laser with echosclerotherapy in our center. Under tumescent anesthesia, venipuncture of the great saphenous vein (GSV) trunk was performed, followed by 1470 nm laser therapy (80-100J/10W). Before the procedure, 1% polidocanol foam was injected into the insufficient collateral veins extending from the main trunk of the GSV. During the 3days after surgery, self-adhesive elastic bandage was used for compression therapy. After 3 days of surgery, grade II compression stockings was used for 1 month. All patients underwent a follow-up duplex Doppler ultrasound 1, 30 days after the procedure. Hospital stay time, postoperative pain, GSV occlusion rate, recurrence rateand complications, such as ecchymosis, edema, paresthesia and endovenous heat-induced thrombosis (EHIT). Results: Four patients were lost to follow up. The average hospitalization time was 2.8 days, the average admission time after operation was 1-2 days. The average operating time was 45.79 ± 8.57min. At the one month follow up all treated GSV remained occluded. There were 2 patients were treated with echosclerotherapy in outpatient because of new reflux in the treated collateral veins. Seventy-five percent of patients did not have any pain after the treatment and ninety-one point eight percent of ones did not take any analgesic tablets at any time after the procedure. No severe complications such as deep venous thrombosis could be detected. And there was no patient developed EHIT after treatment. Minor complications were ecchymosis at 15.1%, edema at 44.8%, and paresthesia around ankle at 0, respectively. All patients expressed satisfaction with the operative curative effects and cosmetic effects. Conclusion: EVLA with 1470-nm diode ring laser with echosclerotherapy in lower limb varicose veins is comfortable with less incision, hospitalization procedure and is a safe and efficient treatment option.