Authors
Agalarov R.M.1, 2, Mazayshvili K.V.1, 2, Markin S.M.1, Kireev R.R.1, Iukhnevich K.S.1
1 Surgut State University, Surgut
2 Vein Center “Antireflux”, Surgut
3 Clinical Hospital RAS, Saint-Petersburg
Abstract
Backgraund: the unsolved problems of the endovenous laser obliteration are carbonized of the radial fiber and its clinging to the vein’s wall, and recanalization of the veins as well. Order to address these problems we developed the new type of fiber is cylindric diffusor with non-stick covering.
Aim: to improve the results of the endovenous laser obliteration by increasing the time of exposure to laser emission on a vein wall and eliminating fiber clinging to a vein.
Methods: There was 15 sheeps in the study. Endovenous laser obliteration was performed for a saphenous vein of the sheep’s limbs using a Biolitec radial fiber (group 1, n = 11) and the modified cylindrical fiber (group 2, n = 12). The operations were done under both the general and tumescent anesthesia. The parameters of the laser obliteration were 1470 nm, 6 Wt, and speed of traction 0,75 cm/sec. The changes in the venous wall were investigated in 5 hours after laser surgery using both the microscopy and the differential scanning calorimetry. The depth of venous wall necrosis, leukocyte infiltration of the media, and damage to the paravasal structures were evaluated.
Results: in the 1st group, multiple clinging of the fiber during the operation was observed, which in 2 cases led to the rupture of the vein. There was not clinging of the fiber in group 2. Regardless of the type of fiber, the complete destruction of the endothelium was detected in all cases. The damage of the venous wall (media) was determined in all segments in group 2, while in group 1 intact segments remained but there was not a statistically significant difference (p>0,05). Leukocyte infiltration of media was absent in the 2nd group, and moderate leukocyte infiltration in some vein segments was observed in the 1st group, but there was not a statistically significant difference (p>0,05). In all cases, regardless of the type of fiber, the damage of the paravasal tissue was detected. In both groups, complete collagen denaturation in the venous wall was observed.
Conclusions: the damage of the all wall layers and paravasal tissue were observed in endovenous laser obliteration regardless of the type of fiber. After laser obliteration with a modified cylindrical fiber, there was no leukocyte infiltration of the media. The protective effect of modified cylindrical fiber from clinging to the vein wall was observed.
Keywords: еndovenous laser ablation, varicose vein.
References
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