Venous wall perforations as the leading reason of a painful syndrome after endovenous laser ablation

Mazaishvili K.V., Stoiko Yu.M., Khlevtova T.V., Kutidze I.A., Morenko D.N.
State Federal Focility «National Medical Surgical Center named after N.I. Piragov under the Ministery of Health and Social development of Russian Federation», Moscow, Russia

This article deals with the problem of venous wall perforation during endovenous laser ablation (EVLA). The sinusoidal type of painful syndrome which arises on 4-7 days after EVLA was shown. A series experiments on the isolated veins using two different lasers were performed. It was demonstrated that vein is squeezed around the fiber during injection of tumescent liquid, which leads to the formation of isolated intimal sinuses. When the blood closed in such sinuses is exposed to laser radiation, it is released of large amounts of gas, which in turn leads to the rupture of the venous wall. Of the earlier idea of perforation of the venous wall with over heated fibre tip has not received confirmation.

KEY WORDS: endovenous laser ablation, venous wall perforations, painful syndrome.

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