ABSTRACT
BACKGROUND: Endovenous laser ablation is a minimally invasive procedure that can be used to treat superficial venous insufficiency. We believe that using a longer wavelength will reduce the frequency of the most common adverse effects associated with the use of shorter wavelengths. OBJECTIVES: To report the results of an initial series of patients with chronic superficial venous insufficiency treated using a 1470 nanometer diode laser and to compare results using linear and radial laser fibers.METHODS: We conducted an observational cohort study. Seventy-four patients, for whom at least two postoperative Doppler ultrasonography scans were available, were recruited with a total of 121 saphenous veins treated (92 great and 29 small saphenous veins). There were 57 patients in Group A (treated with the linear fiber) and 17 in Group B (radial fiber). Follow-up ideally comprised clinical consultation and Doppler ultrasonography at 1 month, 6 months and 12 months after the procedure. Success was defined as total occlusion of the venous segment that had been treated.RESULTS: Success rates at mean follow-up of 13.4 months (range 7 - 27) were 83% for great saphenous veins and 89% for small saphenous veins. Patients treated with the radial fiber required less energy to achieve occlusion of the small saphenous vein and exhibited fewer adverse reactions, with statistical significance. CONCLUSIONS: Treatment of great and small saphenous vein insufficiency using the 1470 nm diode laser is safe and effective. The radial fiber was associated with fewer intercurrent conditions than the linear fiber, although success rates were similar.
CONTEXTO: A ablação endovenosa com laser consiste em um procedimento minimamente invasivo e é aplicada no tratamento da insuficiência venosa superficial. Acreditamos que o uso de uma onda de maior comprimento irá propiciar a diminuição dos principais efeitos adversos, relacionados com ondas de menor comprimento. OBJETIVOS: Demonstrar o resultado de uma série inicial de pacientes com insuficiência venosa crônica superficial, tratados com o uso do Laser Diodo 1470 nanômetros, e comparar as fibras linear e radial.MÉTODOS: Conduzimos um estudo observacional do tipo coorte histórico. Setenta e quatro pacientes, com no mínimo dois eco-Doppler pós-operatórios, foram incluídos, totalizando 121 veias safenas tratadas (92 magnas e 29 parvas). Tivemos 57 pacientes pertencentes ao Grupo A (fibra linear) e 17 ao Grupo B (fibra radial). O follow-up foi idealmente realizado com uma consulta clínica e eco-Doppler em um mês, seis meses e 12 meses, após o procedimento. O sucesso foi definido como a oclusão total do segmento venoso tratado.RESULTADOS: O sucesso no follow-up médio de 13,4 meses (7 - 27) foi de 83% para veias safenas magnas e 89% para veias safenas parvas. Pacientes submetidos ao uso de fibra radial necessitaram de menos energia para oclusão da veia safena parva e apresentaram menos reações adversas, com significância estatística.CONCLUSÃO: O tratamento da insuficiência de veias safenas magna e parva com o Laser Diodo 1470 nm é seguro e eficaz. A utilização da fibra radial foi associada a menos intercorrências em relação à fibra linear, apesar de sucesso semelhante.
Subject(s)
Humans , Male , Female , Middle Aged , Venous Insufficiency/surgery , Venous Insufficiency/therapy , Lasers, Semiconductor/adverse effects , Lasers, Semiconductor/therapeutic use , Treatment Outcome , Benchmarking/methods , Brazil/epidemiology , Echocardiography, Doppler/methods , Observational Study , Risk Factors , Data Interpretation, Statistical , Varicose Veins , Saphenous Vein/surgeryABSTRACT
To study success rate and long term efficacy and complications of the transscleral diode laser Cyclophotocoagulation in refractory glaucoma. In a noncomparative interventional case series, eyes of 9 patients with glaucoma resistant to conventional medical and surgical therapies were treated with transscleral diode laser Cyclophotocoagulation from 2004 to 2007. Criteria for success included intraocular pressure [IOP] of 21 mmHg or less with no devastating complications or need for further glaucoma surgery. Mean IOP had dropped by 50.6% from 47.03 +/- 11.22 mmHg before treatment to 13.2 +/- 7.1 mmHg after surgery [P < 0.001]. The mean number of antiglaucoma medications per eye dropped from 2.78 +/- 0.92 to 1.83 +/- 1.25 [p=0.0001]. Twenty-five [31.6%] eyes suffered deterioration, 14 [17.7%] maintained stability and 23 [29.1%] exhibited improvement of visual acuity. Treatment with cyclophotocoagulation in patients with refractory glaucoma lead to increase in acuity and lower intraocular pressure