Endovenous laser in the treatment of varicose veins of the lower limbs geriatric patient: results of activity for 6 years

Materials and methods 535 limbs of 473 patients (62 bilateral) with VVLL were selected by clinical and ultrasound examination. C class of the CEAP classification of every single limb: C from 3 to 6, Ep, As +/p, Pr. Inclusion criteria: superficial venous insufficiency, venous diameters of less than 15 mm. Exclusion criteria: phlebitis, saphenous aneurysms, congenital malformations, deep venous insufficiency. Age of the patients: range 70–85; right 215, left 320; veins subjected to ELA: GSV 330 (61.7%), SSV (65 (12.1%), peripheral varices incompetence (cases free from GSV and/or SSV incompetence) 105 (19.6%), other incompetent v. districts 35 (6.6%). In the different centers 210 peripheral varices were subjected to ELA: (39.2%), 250 to stab avulsion plus foam sclerotherapy (46.7%), 75 to stab avulsion only (14%); 162 incompetent perforators (30.2%) were subjected to ELA only, 243 (45.4%) were subjected to surgical interruption or foam sclerotherapy. Local or spinal anesthesia was used in one day surgery patients. An endovenous Diode 808 nm laser (Eufoton-Trieste-Italia) was employed, with sterilizable optical fibers of variable diameter from 400 to 1000 microns, by continuous 6–12 W emission power and variable retraction speed from <1 mm/sec to 3 mm/sec. Spinal or local anesthesia were preferred. Tumescent anesthesia and skin protection were seldom applied. All the 535 cases were clinically controlled once at least after 5–7 days. 330 limbs were followed up by duplex examinations from 30 days up to 2 years; 117 were controlled by clinical observation up to 3 years. Follow up and statistical analysis are still in progress.