The late effect of intravenous laser radiation and establishment of laser surgery method for varicose vein in lower extremity

大隐静脉剥脱术一直是治疗下肢静脉曲张的有效方法。静脉腔内的激光辐射可能具有成为低侵入性治疗的潜力。激光照射后静脉闭塞的原理是静脉壁损伤引起的血栓性闭塞，我们用6头体重约40公斤的猪进行了体内实验。将动物分为2组。在一组中，在激光照射上腹部静脉后，在腹部周围使用绷带。在另一组中，没有使用绷带。以10W的能量进行激光辐射。两周后，处死动物，用显微镜分析静脉。所有静脉在激光照射后立即闭塞。结果：1.用绷带组血栓形成强度明显高于另一组（无微通道）。2.动物实验后，对曲张静脉患者的大隐静脉进行激光照射。患者分为2组。在一组中，治疗后仅使用压缩袜。另一组同时使用加压垫。两组静脉闭塞率相同。采用10W和14W激光能量，比较两组治疗后静脉阻塞率和静脉挫伤率，两组静脉阻塞率相同。采用10 W时，治疗后瘀伤的发生率要低得多。综上所述，我们认为采用10 W并使用压缩垫和压缩袜时，激光治疗静脉曲张患者的大隐静脉可能是最佳的。

Usual method for complete treatment of varicose veins in lower extremity has been a stripping surgery of saphenous vein. Laser radiation in the venous lumen may have a potential to be a lower invasive therapy. Principle of venous occlusion after laser radiation is thrombotic occlusion caused by injury on venous wall.We performed in vivo experiment using 6 pigs weighing approximately 40kg. The animals were divided in 2 groups. In one group, bandage was used around abdomen after laser radiation of an epigastric vein. In another group, no bandage was used. Laser radiation was performed at energy of 10W. After two weeks, the animals were sacrificed and the veins were analyzed microscopically. All veins were occluded immediately after laser radiation. Thrombi obtained in the group using bandage tended to be stronger (without micro-canal), compared to those obtained in another group.After animal experiment, laser radiation was performed in great saphenous veins in patient with varicose veins. The patients were divided in 2 groups. In one group, only compression stocking was used after treatment. In another group, compression pad was also used. The rates of venous occlusion in 2 groups were same. The rate of bruising after treatment was much lower in the group with compression pad.The laser energy at 10W and 14W were also adopted and rate of venous occlusion and bruising were compared.The rates of venous occlusion in 2 groups were same. The rate of bruising after treatment was much lower when adopting 10W.In conclusion, we believe that laser treatment of great saphenous vein in patient with varicose veins may be an optimal when adopting 10W and using compression pad with compression stocking.