Endovenous laser treatment

Endovenous laser treatment treats varicose veins using an optical fiber that is inserted into the vein to be treated, and laser light, normally in the infrared portion of the spectrum, shines into the interior of the vein.
This causes the vein to contract, and the optical fiber is slowly withdrawn
During the procedure, a catheter bearing a laser fiber is inserted under ultrasound guidance into the great saphenous vein (GSV) or small saphenous vein (SSV) through a small puncture. The catheter is then advanced, also under ultrasound guidance, to the level of the groin or knee crease. Dilute local anesthesia is injected around and along the vein (perivascular infiltration) using ultrasound imaging to place the local anesthetic solution around the vein, mostly in a sub-facial location. This technique derives from the tumescent local anesthesia (TLA) method long used and proven safe and effective for some methods of liposuction. The laser is activated whilst the catheter or laser fiber is slowly withdrawn, resulting in obliteration of the saphenous vein along its entire length. The treatment, which is performed without sedation, usually takes between 1 and two hours, and the patient walks out under his or her own power. The leg is bandaged and/or placed in a stocking that the patient wears for up to three weeks afterwards.
Foam sclerotherapy or ambulatory phlebectomy is often performed at the time of the procedure or within the first 1–2 weeks to treat branch varicose veins. However, some physicians do not perform these procedures at the time of the ELT because the varicose veins can improve on their own as a result of reduced reflux from the great saphenous vein.
www.gigaalaser.com
donna@gigaalaser.com

Endovenous Laser Therapy - EVLT

What is EVLT?
EVLT is the name for a new technique to remove varicose veins?
How does it work?
A fine tube (catheter) is passed through the skin near the knee and then threaded up the diseased long saphenous vein. The tube is attached to a laser power unit that heats up the end of the catheter. The heat seals the walls of the vein so that no blood can flow through it. The operation is normally done under local anaesthetic but can be done under general anaesthetic.
How is EVLT different from standard surgery?
If you have varicose veins then one of the causes is normally an incompetent long saphenous vein (LSV). Research has shown that it is important to remove this vein to treat varicose veins and reduce the chance of them coming back soon. Standard surgery frequently requires a cut in the groin to disconnect the LSV and then it is removed by a stripping device. This can cause dramatic bruising. EVLT avoids the need for a cut in the groin and there is minimal bruising. This means people who have EVLT can usually return to normal activity sooner than those who have standard treatment.
Is EVLT better than standard surgery?
It is now thought that EVLT is as good as traditional surgery for long saphenous varicose veins.
Doctors normally want to know the results of scientific studies before they are happy that one treatment is better than another. A randomised trial of EVLT and the standard technique has been done by surgeons in Leeds. This has shown that it is a valuable method for treating varicose veins.
We do not know what the recurrence rates of varicose veins after EVLT are. Only time will tell.
Is everyone with varicose veins able to have EVLT?
No. Some people have large, winding veins that are not suitable. Your Vascular Surgeon will be happy to discuss whether your veins are suitable for EVLT. Our research suggests that about 70% of people with varicose veins can be treated with EVLT.
Is EVLT all I need for my veins?
EVLT will remove the major superficial veins, including the LSV and anterior thigh veins. It is, however, usually necessary to have the bulging veins around the calf removed through small cuts called avulsions or have them treated by injections followed by bandages.

www.gigaalaser.com
donna@gigaalaser.com

EVLT-Clinical Picture

www.gigaalaser.com
donna@gigaalaser.com

GREAT SAPHENOUS VEIN VARICOSITIES TREATMENT MANUAL

Clinical Application:
VELAS15w 1470nm diode laser for great saphenous vein varicosities treatment from
GIGAALASER
Clinic Explanation:
Great saphenous vein varicosity is one kind of varicose vein. Veins have leaflet valves to prevent blood from flowing backwards. When the leaflets of the valves no longer meet properly and the valves do not work, this allows blood to flow backwards and they enlarge even more, causing great saphenous vein varicosity.
Endovenous laser treatment is one of the most accepted treatment options for great saphenous vein varicosity. And the 1470nm diode laser be seemed the ideal device for EVLT. It provides safe and highly effective operation. The low energy lever needed using the radial laser fiber significantly minimized adverse effects compared with the bare laser fiber.
Related Keywords:
Varicose vein, great saphenous vein varicosity, thermal ablation, EVLT
Medical device:
VELAS15w 1470nm
Mode: Pulse
Operation power: 3W (LEED 20J/CM) ~5W (LEED30J/CM)
Accessories:
600um radial fiber, EVLT set (Angiographic Catheter+ Guide Wire), 18G needle
Operation procedure:
1. Make the patient in the upright position, inspection the course of GSV, branch varicosities, perforating veins, and then making them on the skin with a surgical pen.
2. Anesthesia: Tumescent local anaesthesia
3. The GSV is inserted at knee level by 18G puncture needle under ultrasound guidance. In case of tortuosity of the GSV, a 2-3-cm incision was made over the GSV to facilitate the procedure.
4. A 5F sheath is then passing over the J-tip guidewire 2-3 cm below the SFJ.
5. Once confirmed the position of the sheath with ultrasonography, a 600um radial-tipped laser fiber is insert. The distal tip of the laser fiber is positioned 2-3 cm below the SFJ
6. Start the device and emit the laser energy. Withdraw the fiber with suggested speed 0.5~1cm/s. Press the red beam by hand to make the fiber tips cling to the vein wall during withdraw the fiber.
Advantage:
1. Minimally invasive procedure
2. More precision and safety, low recurrence
3. Short operation time, less bleeding, pain and ecchymosis
4. Enable the patients quickly back to daily life
Notice:
1. After the treatment, a gauze pad and tape will be placed over the puncture site and a compression stocking or compression bandage will be placed on patient’s leg.
2. Avoid hot tubs, saunas, and other similar activities for two weeks following the procedure as these cause your veins to vasodilate and may open up the treated vein.
3. The patients are encouraged to immediately walk following the procedure and resume normal activities.
4. It is normal to see some bruising along the treatment site as the vein disappears. It will gradually go away within one month.
5. Ask the patient keep standing before operation to make the leg vein 

How Gbox 15B to Treat the Plantar Fasciitis?

The Gbox15B high powered laser therapy treatments for plantar fasciitis pain in fact has proven to be very effective, but more importantly having absolutely no side effects what so ever. 

The Gbox15B delivers the wavelength of 980nm (near infrared) which has deep penetrating ability. It able to penetrate deep into the plantar fascia and repair damaged cells, as well as accelerate the healing of plantar fasciitis and help get you back on your feet quicker than conventioanl treatment methods.

Medical Device

Gbox15B 15W, 980nm

Acute: 4W, 480s, 1920J ;  Chronic: 15W, 600s, 9000J

Accessories:

Therapy Handpiece

www.gigaalaser.com
donna@gigaalaser.com

Varicose Vein Treatments: Is Laser Therapy as Good as Surgery?

Patients with varicose veins wonder which treatment is the best: laser therapy vs. surgery for vein stripping. Well, a new study shows that for varicose veins, the result of saphenous vein insufficiency, laser ablation therapy is as effective and safe as high ligation with vein stripping.

In what researchers described as the largest and most powerful clinical trial to date, comparing an endovenous laser treatment with conventional surgery, the two approaches were equivalent in terms of recurrence even up to 2 years.

Vein stripping (stripping of the great saphenous vein) is the standard surgical approach to the treatment of varicose veins and is done by a vascular surgeon. This current trial looked at 400 patients and compared laser ablation with vein stripping. The recurrence free rates were 97% in both groups which is great, actually. Quality of life scores, pain after the procedure, complication rates, and psychological well-being were the same in both groups.

Minor adverse effects were frequent; however pain persisted longer after vein stripping.

www.gigaalaser.com
donna@gigaalaser.com



Advantages of EVLT (Endovenous Laser Ablation)

1. EVLT can be performed in an office setting without hospitalization
2. Venacure EVLT has a 98% success rate.
3. Early return to normal physical activities with minimal to absent downtime
4. Does not require general anesthesia or preoperative laboratory testing
5. Minimal to absent scarring with the EVLT catheter
6. Typically covered by most insurance plans in some countires

......
www.gigaalaser.com
donna@gigaalaser.com

EVLT VS RF for Varicose Vein

Laser Treatment (EVLT) VS Radiofrequency Ablation (RFA)
There are two “minimally invasive” techniques for varicose vein treatment: Radiofrequency ablation (RFA) and endovenous laser therapy (EVLT).” Most centers offer either laser or radiofrequency ablation. But which is better?
Both techniques are similar, and both are effective ways to treat varicose veins. Both treat venous insufficiency of the large superficial veins by using thermal energy, in the form of laser or radiofrequency energy, to close the blood vessel from the inside.
So how are the treatments different and which one works better?
Radiofrequency ablation targets the vein wall using a radiofrequency wave in 20 second bursts. The collagen of the vein wall is heated which makes the treated vein shrink around the catheter. During the process, the vein actually closes.
Laser treatment also uses a catheter within the vein, but instead of a radiofrequency wave, a laser device is used to target the vein wall. The heating element of the device is quite variable, with frequencies which range from 810 to 1470 nanometers (nm).
So why do many vein clinics use EVLT instead of VNUS closure?
It seems that the main reasons are the cost of the equipment and its operation.
www.gigaalaser.com
donna@gigaalaser.com

1470nm EVLT

The 1470 nm laser is a water-specific laser, targeting water as the chromophore to absorb the laser energy. Since the vein structure is mostly water, it is theorized that the 1470 nm laser wavelength is able to efficiently heat the vein endothelial cells with little chance of collateral damage, resulting in an optimal vein ablation.

The 1470 nm laser allows effective vein ablation with the targeted energy of 30-50 joules/cm at a setting of 5-7 watts.

www.gigaalaser.com
donna@gigaalaser.com

1470nm Varicose Vein Laser

Saphenous Laser Ablation at 1470 nm Targets the Vein Wall, Not Blood
2 comparative studies have demonstrated that patients treated with water-specific laser wavelengths (WSLW) reported less postoperative pain, used less painkillers, and were less likely to have ecchymosis.
There is increasing focus on reducing perioperative pain and bruising while maintaining high saphenous vein ablation rates. A WSLW has become commercially available at 1470 nm in a diode platform. Because the 1470-nm wavelength is preferentially absorbed by water 40 times more than a 980-nm wavelength, the manufacturer hypothesized that it would more readily target the vein wall and more readily ablate veins at lower energy densities, with fewer side-effects.

Who is a candidate for laser therapy?

123

There are no absolute reasons as to why one can not undergo laser therapy. However one should:

• be in good physical health
• be mentally and psychologically stable
• preferably does not smoke
• Wants to improve his/her appearance
• Is realistic about the procedure and results
• Has no disease of the blood vessels or problems with bleeding

www.gigaalaser.com
donna@gigaalaser.com

What are spider veins?

Millions of women and men are troubled by unattractive spider veins on their faces and legs. Spider veins are called as such because they resemble a "star" with numerous small veins radiating from a center point. They may also appear as fine, separate lines, a web-like maze, or as "branches" from a single "tree trunk." It is estimated that more than 75% of females over the age of 18 have spider veins. These red, blue or purple thread-like lines may develop on any part of the body, including the face, but most often appear on the thighs, calves, or buttocks. The condition is associated with increased pressure to the veins.

www.gigaalaser.com to get more info
donna@gigaalaser.com

1470nm EVLT

Currently, at an LEED of 30 ]/cm at 5 watts using tumescent anesthesia and its added benefit of circumferential vein shrinkage, we have experienced 100% closure success in the short term with the 1470-nm laser in this small trial. However, in our everyday practice, we feel that delivering energy using a sliding scale energy protocol based on vein diameter, then shrinking the vein as much as possible with tumescent gives the best opportunity for long-term closure.
The authors conclude that the 1470-nm wavelength EVL system will successfully close saphenous veins and this closure is accomplished with a dramatic reduction in energy. Clinical findings demonstrated a marked reduction in postoperative pain and ecchymoses when compared to our historical control with a 980-nm laser wavelength at contemporary LEED settings; this implies that vein wall perforations are minimized with the 1470-nm system.
www.gigaalaser.com
donna@gigaalaser.com

Saphenous Laser Ablation at 1470 nm Targets the Vein Wall, Not Blood

The 2 primary objectives of this study were to investigate whether the 1470-nm wavelength can close a saphenous vein painlessly and determine safety, efficacy, and side effects of the 1470-nm laser. In all, 26 limbs were treated in the Dominican Republic, with a radially-emitting fiber at low energy ranging from 20 )/cm to 30 Jlcm. Perivenous anesthesia was used selectively. Then 41 veins were treated with the 1470-nm laser at 30 )/cm at 5 watts, using standard perivenous tumescent anesthesia in Miami and compared to a historical control (980 nm, 80 )/cm, and 12 watts). We demonstrated that the 1470-nm wavelength endovenous laser system could not close saphenous veins without use of anesthesia. Closure with a dramatic reduction in energy when compared to a 980-nm wavelength control demonstrated a marked reduction in postoperative pain and ecchymosis; this implies that vein-wall perforations are minimized with this system.

www.gigaalaser.com

donna@gigaalaser.com

EVLT (Endovenous laser treatment) Video

EVLT (Endovenous laser treatment) Video

http://www.gigaalaser.com/video/index.php?act=show&id=15
donna@gigaalaser.com
www.gigaalaser.com

Veins of the leg

https://www.facebook.com/notes/lee-donna/veins-of-the-leg/354069804726905

VELAS15D-15W 1470nm

1470nm EVLT

www.gigaalaser.com
donna@gigaalaser.com

Endovenous laser ablation of varicose veins with the 1470-nm diode laser

Endovenous laser ablation (EVLA) is one of the most accepted treatment options for varicose veins. In previous studies conducted with a laser at 810 to 1320 nm, paresthesia, pain, and ecchymosis were common adverse effects. We hypothesized that a lower linear endovenous energy density (LEED), as used with 1470-nm diode laser fibers, would lead to a reduction in adverse events.

Endovenous laser treatment of varicose veins in the great saphenous vein with the 1470-nm diode laser is safe and highly effective. The lower energy level needed using the radial laser fiber significantly minimized adverse effects compared with the bare laser fiber.

www.gigaalaser.com

donna@gigaalaser.com

1470nm Varicose Vein Laser

www.gigaalaser.com
donna@gigaalaser.com

Saphenous Laser Ablation at 1470nm laser

Keywords:Saphenous laser ablation, Endovenous laser ablation, Diode 1470nm
Clinic Application: Saphenous Laser Ablation at 1470nm laser
Related Keywords: Saphenous laser ablation, Endovenous laser ablation, Diode 1470nm laser.
Medical Device: VELAS 1470nm 15Watt laser
Accessories: Radial fiber, Guidewire, Catherter
Operation procedure:(1) Laser preparation.
Connect 400 micro radial fiber, power 5W (30J/cm) in continuous mode, set the laser ready, check the red aiming beam.
(2)Patient treatment position: supine.
(3) Anesthesia options: epidural anesthesia or general anesthesia or local anesthesia.
(4) Choose the right groin incision of great saphenous vein, ligation and sew up the proximal vein end to heart and block the distalend vein end with the vessel forceps.
(5) Tie a tourniquet above the medial malleolus, find the great saphenous vein, use the 18G puncture needle(with the vein remaining needle) insert the great saphenous vein, get the needle out and leave the remaining needle, put the 0.035” 150cm guidewire into the remaining needle until to the roots of the great saphenous vein at the groin incision.
(6) Pull the puncture needle out and insert the 5F straight catheter through the guidewire until the groin incision.
(7) Get the guidewire out, insert the 400 micro fiber into the straight catheter till the end, pull the straight catheter 3mm-5mm back to keep space between the fiber end and the catheter end. Sew up the distal end vein end.
(8) Raise the patient’s leg 150 to 200 to drain off the blood in the vein. Release the laser, pull the fiber and catheter out together 0.5cm—1cm per second.
(9) Through the skin, check the position of fiber indicator according to the red beam light and press the red indicator to make fiber and vein in contact mode. Treat the entire saphenous vein slowly and get the fiber and catheter out when it is finished.
(10) Cut the 150cm guidewire and 90cm catheter to appropriate length to treat small saphenous vein and perforating vein.
(11) At least two weeks to dress the elastic bandages after surgery.
Postoperation Attention:
(1) Encourage patients to get out of bed in the first postoperative day.
(2) Intramuscular or intravenous antibiotic prophylaxis, a total of 3 to 5 days.
(3) Elastic bandage at least 14 days (different doctors may choose different bandage.
(4) Wear elastic stockings after 3 days later, totally 14 days to 2 months.
(5) Avoid limb hot baths, avoid strenuous physical exercise.
(6) Laser retreatment if recurrence of superficial varicose veins.
Advantage:It is the intracellular water of the vein wall and the water content of blood that offer this opportunity for the 1470nm laser energy and therefore a better application to treat the varicose veins. Because the 1470-nm wavelength is preferentially absorbed by water 40 times more than a 980-nm wavelength, the 1470nm laser will minimize any post-operative pain and bruising and the patients will recovery quickly from the treatment to daily work.

---

www.gigaalaser.com
donna@gigaalaser.com

Gigaa-980nm Laser Liposuction

www.gigaalaser.com