Endovenous Laser Treatment of the Incompetent Lesser Saphenous Vein

Endovenous ablation is widely used for the treatment of incompetent greater saphenous vein these days although it is not common in the incompetent lesser saphenous vein (LSV). Here, we introduce our own technique over endovenous laser treatment (EVLT) of the incompetent LSV and evaluate its efficacy. 29 incompetent LSVs in 27 patients were ablated with EVLT. Under ultrasonography and fluoroscopy, the LSV was punctured and venogram was obtained for verifying the saphenopopliteal junction. With a diode laser fiber (980-㎚ or 810-㎚ wavelength) inserted endovenously after perivenous local anesthesia, laser energy at 12 to 8 Watt was administered in pulsed mode. Sensory, motor and circulation functions were evaluated immediately after the procedure and then in a ward. Doppler ultrasonography was performed at 1 month postoperatively and patients were followed up clinically for 4 to 29 months (mean 14 months). Technical success was achieved in all patients. They all showed complete occlusion of the ablated LSVs 1 month after EVLT. There was partial recanalization in a occluded LSV 29 months postoperatively and there was venous reflux from the popliteal vein to an incompetent, dilated branch just proximal to another occluded LSV 17 months after EVLT. Except for minor complications such as mild wound pains, an itching sense, a transient numbness and a transient mild edema, the patients did not show any other complications. Conclusively, EVLT is safe and effective in ablating the incompetent LSV.