2014年7月31日星期四

EVLA treatment picture




Ultrasound  image showing  the catheter and  the  laser fber inserted in the Saphenous vein




Duplex ultrasound  is performed  in  the upright posi-tion  to map  incompetent  sources of venous  refux and  then  to mark  the  skin  overlying the  incompetent  portion  of  the  great saphenous vein starting at the saphenofemoral junction




Duplex  control  is  used  to  guide  injection  of  7-  to 8-mL  aliquots of  the  following  solution: 10 mL  lidocaine 1% with epinephrine and 10 mL lidocaine 1% without epinephrine and additional 60 mL physiologic serum



To reduce the amount of blood inside the vein, patients are placed in a 15–20° head-down position (Trendelenburg position)



During  laser  irradiation,  the withdrawal of  the  laser fber is controlled to apply a constant linear endovenous energy density (in this case, a metric ruler)



At  the end of  the surgical procedure, venous com-pression  was  applied  for  24  h  by  irremovable  compression bandage

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