Investigation of the effects of endovenous thermocoagulation methods on perivenous and venous tissue in an ex-vivo animal model.

Abstract

The treatment of venous insufficiency involves a variety of techniques. In this study, we evaluated three endovenous ablation modalities: the 980 nm diode laser, the 1470 nm diode laser, and radiofrequency (RF) ablation. The 980 nm diode laser primarily targets hemoglobin, utilizing bare-tip fibers to deliver energy that induces vein closure through photothermal effects. The 1470 nm diode laser exhibits higher absorption by water, employing radial fibers to achieve uniform vein wall heating with reduced collateral damage. RF ablation operates by delivering controlled thermal energy via a catheter, causing collagen contraction and vein closure.​ This study aims to evaluate and compare the efficacy of different endovenous ablation methods for varicose vein disease, with a focus on identifying the treatment modality that results in the least tissue damage. Bovine hind leg veins were utilized for this experimental study. A total of fifteen vein samples were prepared for each of the following treatment modalities: radiofrequency ablation, 980 nm laser, and 1470 nm laser. Following the treatments, the excised veins and surrounding tissues were subjected to histopathological evaluation. Key parameters assessed included vein wall narrowing, surrounding tissue damage, and vein wall perforation for each treatment group. Radiofrequency ablation demonstrated the most favorable outcomes, with no observed tissue loss. The levels of necrosis, coagulation, perforation, vein wall necrosis, and intimal damage were significantly lower in the radiofrequency group compared to both laser ablation groups. Among the laser treatments, the 1470 nm laser exhibited better safety profiles compared to the 980 nm laser. Based on our findings, both radiofrequency ablation and 1470 nm laser treatment appear to be more reliable than the 980 nm laser in terms of minimizing vascular wall and surrounding tissue damage. Radiofrequency ablation, in particular, emerged as the safest modality, showing the least adverse effects on vascular structures.