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Case Reports
. 2024 Sep 20:12:383.
doi: 10.12688/f1000research.131695.4. eCollection 2023.

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Taofan Taofan  1 , Iwan Dakota  1 , Achmad Hafiedz Azis Kartamihardja  2 , Jonathan Edbert Afandy  3 , Suci Indriani  1 , Suko Adiarto  1
Affiliations
Case Reports

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Taofan Taofan et al. F1000Res. .

Abstract

Background: Active venous leg ulcer (VLU) is the most severe manifestation of chronic venous disease which not only affects patients' health, but also decreases the quality of life, and delivers economic burdens. Treatment of superficial venous reflux with early endovenous laser ablation (EVLA) has been associated with reducing ulcer recurrence levels and promoting faster VLU healing. We reported three cases of patients with active VLU undergoing EVLA with different approaches.

Case illustration: Three patients came with complaint of leg ulcer, diagnosed with C6sEpAsdPr, with venous clinical severity scores (VCSS) of 15, 23, and 22 respectively. Severe great saphenous veins (GSV) reflux was found in all patients by duplex ultrasound examination. The second patient had undergone above-the-knee EVLA. All patients underwent EVLA using 1470-nano meter wavelength laser device and ELVeS radial fiber (Biolitec, Bonn, Germany). The laser energy protocol used was 6 W linear endovenous energy density (LEED) 50 J/cm for proximal until media ATK GSV ablation, 5 W LEED 40 J/cm for media ATK until proximal below-the-knee (BTK) GSV, and 2 W LEED 20 J/cm for proximal until distal BTK GSV. The third patient was also treated with EVLA for small saphenous vein severe reflux. Follow-up until 6 months post-EVLA showed significant healing of the ulcer with 14, 16, and 17 VCSS reduction consecutively without any complication.

Conclusion: We've reported three cases of patients with active VLU undergoing EVLA until BTK with significant results. The EVLA of GSV until BTK where there is still significant reflux is safe and provides satisfactory results in patients with VLU.

Keywords: below the knee; complication; endovenous laser ablation; laser power; outcome; venous leg ulcer.

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Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. The 1 st patient rapid progression of venous ulcer healing.
A. pre-EVLA; B. 1-week post-EVLA.
Figure 2.
Figure 2.. Venous leg ulcer healing progression of the 2 nd patient.
A. pre-EVLA; B. 6-months post EVLA.
Figure 3.
Figure 3.. Lower extremity duplex ultrasound of the 2 nd patient.
A. Obliterated segment of above-the-knee left GSV; B. persistent reflux of below-the-knee GSV (968 ms).
Figure 4.
Figure 4.. Venous leg ulcer healing progression of the 3 rd patient.
A. pre-EVLA; B. 6-months post EVLA.
See this image and copyright information in PMC

Comment on

References

    1. Maeseneer MGD, Kakkos SK, Aherne T, et al. : Editor’s Choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur. J. Vasc. Endovasc. Surg. 2022 Feb 1;63(2):184–267. 10.1016/j.ejvs.2021.12.024 - DOI - PubMed
    1. Berenguer Pérez M, López-Casanova P, Sarabia Lavín R, et al. : Epidemiology of venous leg ulcers in primary health care: Incidence and prevalence in a health centre—A time series study (2010-2014). Int. Wound J. 2019;16(1):256–265. 10.1111/iwj.13026 - DOI - PMC - PubMed
    1. Homs-Romero E, Romero-Collado A, Verdú J, et al. : Validity of Chronic Venous Disease Diagnoses and Epidemiology Using Validated Electronic Health Records From Primary Care: A Real-World Data Analysis. J. Nurs. Scholarsh. 2021;53(3):296–305. 10.1111/jnu.12639 - DOI - PubMed
    1. Folguera-Álvarez C, Garrido-Elustondo S, Rico-Blázquez M, et al. : Factors Associated With the Quality of Life of Patients With Venous Leg Ulcers in Primary Care: Cross-Sectional Study. Int. J. Low Extrem. Wounds. 2020 Oct 26;21:521–528. 10.1177/1534734620967562 - DOI - PubMed
    1. Phillips CJ, Humphreys I, Thayer D, et al. : Cost of managing patients with venous leg ulcers. Int. Wound J. 2020;17(4):1074–1082. 10.1111/iwj.13366 - DOI - PMC - PubMed

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