Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.200244
Jornal Vascular Brasileiro
Original Article

Uso do laser de 1.470 nm para o tratamento de insuficiência venosa superficial

Use of 1,470 nm laser for treatment of superficial venous insufficiency

Manuella Bernardo Ferreira; Gilberto do Nascimento Galego; Nazaré Otília Nazário; Rafael Narciso Franklin; Pierre Galvagni Silveira; Cristiano Torres Bortoluzzi; Daniel Ishikawa; Fernando Wolf

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Resumo

Resumo: Contexto: Existem diversas formas de tratamento de varizes de membros inferiores. Entre elas, destaca-se o uso do laser diodo de 1.470 nm. Essa técnica proporciona aos pacientes uma cirurgia em regime ambulatorial, com retorno precoce à atividade ocupacional, bom resultado estético e baixo índice de complicações. No entanto, ainda se discute exaustivamente variáveis como comprimento de onda do laser, potência aplicada em cada área, tipo de fibra, necessidade ou não de tumescência e densidade de energia endovenosa linear.

Objetivos: Analisar os resultados do tratamento da insuficiência venosa superficial com laser diodo de 1.470 nm.

Métodos: Estudo retrospectivo, realizado em uma clínica privada de um hospital privado em Florianópolis a partir de dados colhidos prospectivamente. As amostras eram de 287 pacientes submetidos à cirurgia para tratamento da insuficiência venosa superficial com laser diodo de 1.470 nm, de janeiro de 2016 a dezembro de 2018, totalizando 358 veias safenas magnas e 84 veias safenas parvas tratadas.

Resultados: A taxa de oclusão total após 12 meses de cirurgia foi de 94,4%, com densidade de energia endovenosa linear média de 45,90 J/cm nas veias safenas magnas e de 96,4% com densidade de energia endovenosa linear média de 44,07 J/cm nas veias safenas parvas.

Conclusões: No período acompanhado, o laser diodo de 1.470 nm mostrou-se um tratamento seguro, muito efetivo e com baixas taxas de complicações (dor, edema, equimose, trombose venosa profunda e trombose induzida pelo calor endovenoso).

Palavras-chave

insuficiência venosa, varizes, angioplastia a laser, técnicas de ablação

Abstract

Background: There are several ways to treat varicose veins of the lower limbs, among which use of 1470nm diode lasers stands out. This technique can be used to treat patients in outpatient settings, with early return to work, good esthetic results, and low rates of complications. However, variables such as the laser wavelength, the power administered in each area, the type of fiber, and the linear intravenous energy density (LEED) are still extensively discussed. Objectives: To analyze the results of superficial venous insufficiency treatment with a 1470nm diode laser. Methods: Retrospective study conducted at a private clinic in a private hospital in Florianopolis, based on a database collected prospectively. The sample comprised 287 patients who underwent surgery to treat superficial venous insufficiency with 1470nm diode laser, from January 2016 to December 2018, totaling 358 great saphenous veins (GSVs) and 84 small saphenous veins (SSVs) treated. Results: The total occlusion rates after 12 months of surgery were 94.4% in the GSVs, with an average LEED of 45.90 J/cm, and 96.4% in the SSVs, with an average LEED of 44.07 J/cm. Conclusions: During the follow-up period, the 1470nm diode laser proved to be a safe treatment, with great efficacy and low rates of complications (pain, edema, bruising, deep vein thrombosis, and endothermal heat-induced thrombosis - EHIT).

Keywords

venous insufficiency; varicose veins; laser angioplasty; intravenous ablation.

References

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Submitted date:
12/28/2020

Accepted date:
04/12/2021

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