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Clinical Application

Great saphenous veins (GSV) with medical diode laser system from GIGAALASER

Keywords: endovenous laser treatment (ELT),great saphenous veins (GSV),linear endovenous energy density (LEED),saphenofemoral junction (SFJ),crural segment,condylar segment, sural segment

Clinical Application: Great saphenous veins (GSV) with medical diode laser system from GIGAALASER
Clinic Explanation: (GSV) reflux is the most common underlying cause of significant varicose veins.
Related Keywords:  endovenous laser treatment (ELT),great saphenous veins (GSV),linear endovenous energy density (LEED),saphenofemoral junction (SFJ),crural segment,condylar segment, sural segment Medical device: VELAS 30W 980nm (continuous)
Accessories: 600um optical fiber 21-gauge needle guidewire catheter duplex ultrasound imaging Operation procedure: Patient selection Measure GSV diameter by Duplex ultrasonography in an upright position in different segments to to select the appropriate LEED for each segment.
Treatment parameter: Laser setting:
Power: 10 W
Operation mode: continuous
1. During treatment, patients were maintained in theTrendelenburg position(which the patient is on an elevated and inclined plane at 20° with the head downand legs and feet over the edge of the table)
2. Connect fiber to diode laser system.
3. Puncture saphenous vein at the knee level with a 21-gauge needle under ultrasound guidance.
4. A 5F micro guidewire thread through the needle up to the SFJ, then a 0.035-inch catheter was placed over the guidewire under ultrasound guidance,
5. Withdraw guidewire and put fiber into the vein, turn 10 W in continuous mode to burning, using a graduated scale and slowly withdrawn fiber and catheter in 3-mm increments. Patients should have a compression bandage for 24 hours, wear stockings with full-thigh for 3 weeks.
6. Patients should walk immediately after the procedure and to continue their normal daily activities with vigorous workouts. 7. All patients should have piroxicam drug for 5 days.
8. Follow-up examinations
Advantage:
1. No observed side effects even when using high fluencies.
2. The diode laser is small, mobile, low maintenance, and relatively inexpensive. Diodes are extremely long lived as compared to laser tubes.
Notice:
1. LEED was tuned as GSV diameters measure.
2. Adjust pulse duration for each individual GSV segment from 1.2 seconds (2 mm) up to 6 seconds (10 mm).
3. The last pulse was controlled by duplex ultrasound imaging to avoid any skin burn and delayed healing.

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