Complication rate with the 1940-nm versus 1470-nm wavelength laser.

Background: We hypothesized, that endovenous laser ablation (EVLA) with the highly water specific 1940-nm wavelength laser would reduce ablation-related thrombus extension (ARTE) incidence compared to the less specific 1470-nm laser.

Materials and methods: Between February 2017 to March 2023 we identified a consecutive series of patients undergoing EVLA from the prospectively ongoing VEINOVA registry. Patients were treated with the 1940-nm or 1470-nm laser. Demographic data and outcome data were used for this retrospective analysis.

Results: From a total of 3055 EVLA, 2006 procedures were performed with the1470-nm and 1049 with the 1940-nm laser. At 2-6 days follow- up visit (follow up visit 1), all ARTE occurred in 18 (0.9%) of all procedures with the 1470-nm and in 1 (0.1%) with the 1940-nm laser (p = 0.023). DVT was similar in both groups (0.3% vs 0.2%, p = 0.784). Phlebitis occurred in 67 (3.3%) of all procedures with the 1470-nm and in 2 (0.2%; p = 0.003) with the 1940-nm laser and paresthesia in 99 (4.9%) versus 5 (0.5%; p < 0.001), respectively. At 5-6 weeks follow-up (follow up visit 2), all ARTE occurred in 27 (1.4%) of all procedures with the 1470-nm and in 4 (0.4%; p = 0.010) with the 1940-nm laser. DVT was similar in both groups (0.7% vs 0.4%; p = 0.846). Phlebitis occurred in 97 (4.8%) of all procedures with the 1470-nm and in 9 (0.9%; p < 0.001) with the 1940-nm laser and paresthesia in 194 (9.7%) versus 35 (3.3%; p < 0.001), respectively. Occlusion rate was in both groups similar (99.8% vs 99.6%).

Conclusion: EVLA using the 1940-nm laser appears to be safe with lower ARTE incidence than using the 1470-nm laser. Phlebitis and paresthesia occurred less frequent with the 1940-nm than with the 1470-nm laser, thus favoring the use of the 1940-nm laser.