Endovenous loser treatment with the 980 nm diodeloser in patients with venous leg ulcers

Intention: Minimal invasive methods like endovenous loser treatment (ELT) have recently gained more interest in the treatment of varicose veins. However, reports concerning treatment of venous ulcer patients by ELT are rare. This study was intended to demonstrate that ELT is a good option in these complicated patients. Patients, material, methods: In this not randomized, prospective study 13 unselected venous ulcer patients (12 women, 1 man) from the phlebologicol department of dermatologic university hospital of Bonn were included. All had varicosities of the great or small saphenous veins demonstrated by duplex. The mean age was 75.7 years, the mean weight 75.5 kg and the mean height 168 cm. All patients had a standardized follow up after six months and one year clinically and for flow, reflux and occlusion of the treated vein by duplex. Three years after ELT all patients where questioned by phone. ELT was performed with a 980 nm diode laser in a pulsed mode and under local tumescence anoesthesia. Results: One year after ELT in all of the 13 patients the ulcer was healed. After three years one patient had a recurrent venous ulcer. Six month after ELT in one patient (7.7%) reflux 3 and 20 cm below the junction was detected. The mean diameter of the treated vein at 3 cm below the junction was reduced from 9.7 mm (SD 2.8 mm) to 1.8 mm (SD 2.0 mm) within one year. In the some time quality of life, measured by the CIVIQ questionnaire improved significantly from 62.4 (SD 14.3) to 43.8 (SD 23.2). No treatment related severe adverse events like DVT occurred. Canclusions: ELT is a save method to treat varicose veins in venous ulcer patients at a low risk. The low recurrence rate of venous reflux after one year (7.7%) and the low risk profile of the method make it an alternative to stripping an even foam sclerotherapy.