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Phlebologie 2003; 32(05): 131-137
DOI: 10.1055/s-0037-1621456
Originalarbeit
Schattauer GmbH

Endovenöse Lasertherapie der Varikose

Endovenous laser treatment for varicose veinsLa thérapie endoveineuse au laser de la varicose
T. M. Proebstle
1   Universitätshautklinik (Direktor: Prof. Dr. J. Knop) Mainz
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Publikationsdatum:
30. Dezember 2017 (online)

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Zusammenfassung

Endoluminale Techniken scheinen sich zu einer bedeutenden methodischen Erweiterung in der operativen Therapie der Varikose zu entwickeln. An die Stelle der Beseitigung pathologischer Refluxe durch chirurgische Entfernung des ganzen Gefäßes tritt die alleinige Okklusion des Gefäßlumens, um so eine Normalisierung der Hämodynamik zu erreichen. Auf Grund ihrer guten Steuerbarkeit und ihren verhältnismäßig schnellen Durchführbarkeit hat die endovenöse Lasertherapie (ELT) eine herausgehobene Position gegenüber anderen endoluminalen Verfahren. Die vorliegende Arbeit stellt Entwicklung, Wirkungsweise und Effizienz der ELT dar und präsentiert eigene Ergebnisse von über 500 Eingriffen mit dem 940-nm-Diodenlaser seit Anfang 2001.

Summary

Endoluminal techniques seem to move towards a relevant methodological extension of the operative treatment of varicose veins. Instead of abolishing pathological refluxes by surgical removal of the whole vessel, only the lumen is occluded to normalize haemodynamics. Because of its precise adjustability and its relatively short time for treatment, endovenous laser treatment (ELT) has an outstanding position as compared to other endoluminal techniques. The paper presented here addresses development, mode of action and efficacy of ELT. Furthermore, own results of more than 500 procedures with the 940 nm diode laser since 2001 are shown.

Résumé

Les techniques endoluminales semblent prendre une place de plus en plus importante dans le traitement chirurgical de la varicose. Les reflux pathologiques ne sont pas éliminés par une ablation chirurgicale du vaisseau entier mais l’hémodynamique est normalisée par un blocage de la lumière du vaisseau uniquement. Grâce à sa précision et à sa mise en oeuvre relativement rapide, la thérapie endoveineuse au laser (TEL) occupe une place importante par rapport à d’autres techniques endoluminales. Le présent article expose le développement, le mode d’action et l’efficacité de la TEL. En outre, les résultats obtenus depuis 2001 lors de plus de 500 interventions réalisées à l’aide d’un laser à diode de 940 nm sont présentés.

Schlüsselwörter

Varikose - endovenöse Lasertherapie

Keywords

Varicose veins - endovenous laser treatment

Mots clés

Varicoses - traitement endoveineux au laser
 

  • Literatur

  • 1 Babcock WW. A new operation for the exstirpation of the varicose veins of the leg. NY Med J 1907; 86: 153.
    Google Scholar
  • 2 Campall WB, Vijay Kumar A, Collin TW. et al. The outcome of varicose vein surgery at 10 years: clinical findings symptom and patient satisfaction. Ann R Coll Surg Engl 2003; 85: 52-7.
    CrossrefPubMedGoogle Scholar
  • 3 Chandler JG, Pichot O, Sessa C. et al. Defining the role of extended saphenofemoral junction ligation prospective comparative study. J Vasc Surg 2000; 32: 941-53.
    CrossrefPubMedGoogle Scholar
  • 4 Chang CJ, Chua JJ. Endovenous laser photocoagulation (EVLP) for varicose veins. Lasers Surg Med 2002; 31: 257-62
    CrossrefPubMedGoogle Scholar
  • 5 Cohn MS, Seiger E, Goldman S. Ambulatory phlebectomy using tumescent technique for local anesthesia. Dermatol Surg 1996; 22: 657-62.
    PubMedGoogle Scholar
  • 6 Fischer R, Chandler JG, De Maeseneer MG. et al. The unresolved poblem of recurrent saphenofemoral reflux. J Am Coll Surg 2002; 195: 80-94.
    CrossrefPubMedGoogle Scholar
  • 7 Fischer R, Kluess HG, Frings N. et al. Der aktuelle Stand der Magnakrossenrezidiv-Forschung. Phlebologie 2003; 32: 54-9.
    Artikel in Thieme ConnectGoogle Scholar
  • 8 Frullini A, Cavezzi A. Sclerosing foam in the treatment of varicose veins and telangiectases: history and analysis of safety and complications. Dermatol Surg 2002; 28: 11-5
    PubMedGoogle Scholar
  • 9 Garde C. Cryosurgery of varicose veins. J Dermatol Surg Oncol 1994; 20: 56-8.
    CrossrefPubMedGoogle Scholar
  • 10 Gerard JL, Desgranges P, Becquemin JP. et al. Feasibility of ambulatory endovenous laser for the treatment of greater saphenous varicose veins: one-month outcome in a series of 20 outpatients. J Mal Vasc 2002; 27: 222-5.
    PubMedGoogle Scholar
  • 11 Goldman MP. Closure of the greater saphenous vein with endoluminal radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: preliminary 6-month follow-up. Dermatol Surg 2000; 26: 452-6.
    CrossrefPubMedGoogle Scholar
  • 12 Min RJ, Navarro L. Transcatheter duplex ultrasound- guided sclerotherapy for treatment of greater saphenous vein reflux: preliminary report. Dermatol Surg 2000; 26: 410-4.
    CrossrefPubMedGoogle Scholar
  • 13 Min RJ, Zimmet SE, Isaacs MN. et al. Endovenous laser treatment of the incompetent greater saphenous vein. J Vasc Interv Radiol 2001; 12: 1167-71.
    CrossrefPubMedGoogle Scholar
  • 14 Navarro L, Min R, Boné C. Endovenous laser: a new minimally invasive method of treatment of varicose veins – preliminary observations using an 810 nm diode laser. Dermatol Surg 2001; 27: 117-22.
    PubMedGoogle Scholar
  • 15 Oesch A. Formen und moderne Therapie der Varikose. Schweiz Med Wschr 1988; 118: 1242-7.
    PubMedGoogle Scholar
  • 16 Proebstle TM, Gül D, Kargl A. et al. Endovenous laser treatment of the lesser saphenous vein with a 940 nm diode laser – early results. Dermatol Surg 2003; 29: 357-61.
    PubMedGoogle Scholar
  • 17 Proebstle TM, Gül D, Kargl A. et al. Non-occlusion and early reopening of the great saphenous vein after endovenous laser treatment is fluence dependent. Dermatol Surg. 2003 in press.
    PubMedGoogle Scholar
  • 18 Proebstle TM, Gül D, Lehr HA. et al. Infrequent early recanalization of the greater saphenous vein after endovenous laser treatment. J Vasc Surg,. 2003 in press.
    PubMedGoogle Scholar
  • 19 Proebstle TM, Lehr HA, Kargl A. et al. Endovenous treatment of the greater saphenous vein with a 940 nm diode laser: thrombotic occlusion after endoluminal thermal damage by lasergenerated steam bubbles. J Vasc Surg 2002; 35: 729-36.
    CrossrefPubMedGoogle Scholar
  • 20 Proebstle TM, Paepcke U, Weisel G. et al. High ligation and stripping of the long saphenous vein using the tumescent technique for local anesthesia. Dermatol Surg 1998; 24: 453-6.
    PubMedGoogle Scholar
  • 21 Proebstle TM, Sandhofer M, Kargl A. et al. Thermal damage of the inner vein wall during endovenous treatment: key role of energy absorption by intravascular blood. Dermatol Surg 2002; 28: 596-600.
    PubMedGoogle Scholar
  • 22 Sadick NS, Schanzer H. Combined high ligation and stab avilsion for varicose veins in an outpatient setting. Dermatol Surg 1998; 24: 475-9.
    PubMedGoogle Scholar
  • 23 Sperling M, Lacutiva A. Die Invaginationsextraktion. Chirurg 1985; 56: 90-4.
    PubMedGoogle Scholar
  • 24 Tessari L, Cavezzi A, Frullini A. Preliminary expirience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg 2001; 27: 58-60.
    PubMedGoogle Scholar
  • 25 Trendelenburg F. Über die Unterbindung der Vena saphena magna bei Unterschenkelvarizen. Beiträge zur Klinischen Chirurgie 1890; 7: 195.
    Google Scholar
  • 26 Van der Stricht J. Saphenectomie par invagination sur fil. Press Med 1963; 21: 1081-2.
    Google Scholar
  • 27 Weiss RA. Comparison of endovenous radiofrequency versus 810 nm diode laser occlusion of large veins in an animal model. Dermatol Surg 2002; 28: 56-61.
    PubMedGoogle Scholar
  • 28 Zimmet SE, Min RJ. Temperature changes in perivenous tissue during endovenous laser treatment in a swine model. J Vasc Interv Radiol 2003; 14: 911-5.
    CrossrefPubMedGoogle Scholar