Ex Vivo Evaluation of Endothelial and Adventitial Temperature during Endovenous Laser Ablation Using a 1470-nm Radial 2ring Slim Fiber: Porcine Jugular Vein Model.

Abstract

Objectives: Endovenous laser ablation (EVLA) using a 1470-nm radial 2-ring slim fiber is widely performed, but optimal ablation settings remain empirical. This ex vivo study aimed to evaluate the effects of ablation conditions on endothelial and adventitial temperature dynamics, providing insights into both treatment efficacy and safety.

Methods: Porcine jugular veins were used in an ex vivo model. EVLA was performed using a 1470-nm diode laser with the 2-ring slim fiber under 2 conditions: 5W with a linear endovenous energy density (LEED) of 25 J/cm and 6.5W with a LEED of 65 J/cm. Endothelial and adventitial temperatures were continuously measured at 0.1-second intervals. Cumulative durations with endothelial temperature ≥70°C and adventitial temperature ≥43°C were assessed.

Results: Endothelial temperatures reached ≥70°C under both conditions, with a longer duration observed at 6.5W. Cumulative adventitial exposure ≥43°C was prolonged at 6.5W, whereas it remained minimal at 5W.

Conclusions: In this ex vivo model, 6.5W with a LEED of 65 J/cm tended to produce more sustained endothelial and adventitial thermal exposure, whereas 5W with a LEED of 25 J/cm tended to produce lower adventitial exposure. Although further clinical validation is required, segment-specific settings may be reasonable.