For last two decades, endovenous laser therapy (EVLT) is one of the most widely accepted surgical options for treating incompetent great and small saphenous veins. However, due to excessive heating during EVLT, the major complications include pain and burning that often increase the risk of dermatitis disease. The aim of the current study was to quantitatively compare commercially-available radial fibers with newly-developed diffusing applicators for 1470 nm-EVLA in terms of temperature elevation and vein deformation. Rabbit veins were used as an ex vivo model for EVLA. A 5-W 1470 nm laser system in conjunction with the radial and diffusing fibers was employed to thermally coagulate the venous tissue. A goniometric measurement validated uniform and isotropic distribution of laser light in polar and longitudinal directions (i.e., normalized intensity = 0.84±0.08). The diffusing applicator induced a 20 % lower maximum temperature than the radial fiber did (maximum temperature = 79.2 °C for radial vs. 63.3 °C for diffusing). Due to higher irradiance, the radial fiber was associated with a transient temperature change of 5.9 °C/s, which was 1.5-fold faster than the diffusing applicator (i.e., 2.4 °C/s). However, the degree of cross-sectional area reduction in the veins was almost comparable for both the fibers (i.e., 53% for radial vs. 48% for diffusing). Due to longer irradiation length, the diffusing applicator demonstrated wider treatment coverage and less fiber speed-dependent. On account of easy pullback technique and uniform thermal effect, the proposed cylindrically diffusing applicator can be a feasible optical device to effectively treat varicose veins. Further in vivo studies will be performed to identify the complete removal of the vein disease and healing response of the venous tissue.
Gia Truong Van and Hyun Wook Kang, "Quantitative comparison between radial and cylindrically diffusing fibers for photothermal treatment of varicose vein disease (Conference Presentation)," Proc. SPIE 10042, Diagnostic and Therapeutic Applications of Light in Cardiology, 100420G (Presented at SPIE BiOS: January 28, 2017; Published: 19 April 2017); https://doi.org/10.1117/12.2250754.5369982358001.
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