Endovenous laser treatment with 1320nm Nd : YAG laser for primary varicose veins

目的：探讨1320nm静脉内激光治疗（ELVT）的有效性和安全性。患者与方法：对32例原发性静脉曲张患者37肢进行治疗。脉冲（50Hz）激光能量为5瓦，同时光纤以m/秒的速度被拉回系统。结果：治疗1年后，虽然初始封堵成功率为100%，静脉充盈指数基本正常，但平均随访633 d后，临床复发率为16.2%。复发肢体的线性静脉内能量密度（LEED）明显降低（45.5±5.6 vs 52.3±12.3 J/cm, p<0.05）。没有重大并发症。轻微并发症包括中度挫伤4例，轻度疼痛6例，隐神经损伤1例。结论：1320 nm EVLT是一种安全有效的治疗方法，但LEED大于50 J/cm可能需要充分闭塞隐静脉。

Objective: To clarify the efficacy and safety of a 1320 nm endovenous laser treatment (ELVT).Patients and Methods: Thirty-seven limbs in 32 patients with primary varicose veins were treated. Pulsed (50Hz) laser energy was applied at 5 Watts while the fiber was retracted at a speed of m/sec by the pull back system.Results: Although the initial success (occlusion) rate was 100% and the venous filling index was almost normal at 1 year after treatment, the clinical recurrence rate was 16.2% after a mean follow-up period of 633 days. The linear endovenous energy density (LEED) was significantly lower in the limbs with recurrence (45.5±5.6 vs. 52.3±12.3 J/cm, p<0.05). There was no major complication. Minor complications included 4 moderate bruising, 6 mild pains, and 1 saphenous nerve injury.Conclusion: 1320 nm EVLT was a safe and effective treatment, but a LEED of greater than 50 J/cm might be necessary to occlude the saphenous vein sufficiently.