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Erschienen in: Gefässchirurgie 7/2014

01.11.2014 | Leitthema

Endovenöse Lasertherapie der Varikose – Evidenz und Perspektiven

verfasst von: PD Dr. C.-G. Schmedt, S. Dikic, A. Esipova, S. Demhasaj, T. Küspert, R. Sroka

Erschienen in: Gefässchirurgie | Ausgabe 7/2014

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Zusammenfassung

Hintergrund

Die endovenöse Lasertherapie (ELT) wird seit etwa 15 Jahren zur Therapie der Stammveneninsuffizienz klinisch angewendet. Charakteristisch für die ELT ist ein weites Spektrum unterschiedlicher Behandlungsprotokolle mit Verwendung verschiedener Lasersysteme und endovenöser Applikationsformen.

Fragestellung

Welchen Stellenwert hat die ELT und kann sie durch weitere Maßnahmen optimiert werden?

Material und Methoden

Auswertung zahlreicher kontrollierter Studien und Metaanalysen sowie mehrerer evidenzbasierter Behandlungsleitlinien.

Ergebnisse

Experimentelle Untersuchungen und klinische Daten deuten darauf hin, dass die ELT durch mehrere Maßnahmen weiter optimiert werden kann. Hierzu zählen die Verwendung von Lasergeneratoren mit längeren Wellenlängen und radial abstrahlenden Lichtwellenleitern sowie die zunehmende Standardisierung der Behandlung mit adäquater Dosimetrie, welche die Durchmesser der behandelten Vene berücksichtigt. Allerdings sind weitere kontrollierte Studien erforderlich, um die Effektivität der ELT zu untermauern und mit anderen endovenösen thermischen, chemischen und mechanochemischen Therapieverfahren und der offenen chirurgischen Therapie mit Krossektomie und Stripping zu vergleichen. Hierdurch können die optimalen Indikationsbereiche der einzelnen Behandlungsformen erarbeitet werden.
Literatur
1.
Zurück zum Zitat Agus GB, Mancini S, Magi G for the IEWG (2006) The first 1000 cases of Italian Endovenous-laser Working Group (IEWG). Rationale, and long-term outcomes for the 1999–2003 period. Int Angiol 25:209–215PubMed Agus GB, Mancini S, Magi G for the IEWG (2006) The first 1000 cases of Italian Endovenous-laser Working Group (IEWG). Rationale, and long-term outcomes for the 1999–2003 period. Int Angiol 25:209–215PubMed
2.
Zurück zum Zitat Almeida JI, Kaufman J, Göckeritz O et al (2009) Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERYstudy). J Vasc Interv Radiol 20:752–759PubMedCrossRef Almeida JI, Kaufman J, Göckeritz O et al (2009) Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERYstudy). J Vasc Interv Radiol 20:752–759PubMedCrossRef
3.
Zurück zum Zitat Biemans AAM, Kockaert M, Akkersdijk GP et al (2013) Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg 58:727–734PubMedCrossRef Biemans AAM, Kockaert M, Akkersdijk GP et al (2013) Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg 58:727–734PubMedCrossRef
4.
Zurück zum Zitat Boné C (1999) Tratamiento endoluminal de las varices con laser de diodo. Estudio preliminary. Rev Pathol Vasc 5:35–46 Boné C (1999) Tratamiento endoluminal de las varices con laser de diodo. Estudio preliminary. Rev Pathol Vasc 5:35–46
5.
Zurück zum Zitat Brar R, Nordon IM, Hinchliffe RJ et al (2010) Surgical management of varicose veins: meta-analysis. Vascular 18:205–220PubMedCrossRef Brar R, Nordon IM, Hinchliffe RJ et al (2010) Surgical management of varicose veins: meta-analysis. Vascular 18:205–220PubMedCrossRef
6.
Zurück zum Zitat Carradice D, Mekako AI, Mazari FAK et al (2011) Clinical and technical outcomes from a randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins. Br J Surg 98:1117–1123PubMedCrossRef Carradice D, Mekako AI, Mazari FAK et al (2011) Clinical and technical outcomes from a randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins. Br J Surg 98:1117–1123PubMedCrossRef
7.
Zurück zum Zitat Carradice D, Mekako AI, Mazari FAK et al (2011) Randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins. Br J Surg 98:501–510PubMedCrossRef Carradice D, Mekako AI, Mazari FAK et al (2011) Randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins. Br J Surg 98:501–510PubMedCrossRef
8.
Zurück zum Zitat Caroll C, Hummel S, Leaviss J et al (2014) Systematic review, network meta-analysis and exploratory cost-effectiveness model of randomized trials of minimally invasive techniques versus surgery for varicose veins. Br J Surg 101:1040–1052CrossRef Caroll C, Hummel S, Leaviss J et al (2014) Systematic review, network meta-analysis and exploratory cost-effectiveness model of randomized trials of minimally invasive techniques versus surgery for varicose veins. Br J Surg 101:1040–1052CrossRef
9.
Zurück zum Zitat Cavallini A (2014) Endovenous laser treatment of saphenous veins: is there clinical difference using different endovenous laser wavelenghts? Int Angiol (Epub ahead of print) Cavallini A (2014) Endovenous laser treatment of saphenous veins: is there clinical difference using different endovenous laser wavelenghts? Int Angiol (Epub ahead of print)
10.
Zurück zum Zitat Christenson JT, Gueddi S, Gemayel G, Bounameaux H (2010) Prospective randomized trial comparing endovenous laser ablation and surgery for treatment of primary great saphenous varicose veins with a 2-year follow-up. J Vasc Surg 52:1234–1241PubMedCrossRef Christenson JT, Gueddi S, Gemayel G, Bounameaux H (2010) Prospective randomized trial comparing endovenous laser ablation and surgery for treatment of primary great saphenous varicose veins with a 2-year follow-up. J Vasc Surg 52:1234–1241PubMedCrossRef
11.
Zurück zum Zitat Medeiros CA de, Luccas GC (2005) Comparison of endovenous treatment with an 810 nm laser versus conventional stripping of the great saphenous vein in patients with primary varicose veins. Dermatol Surg 31:1685–1694PubMed Medeiros CA de, Luccas GC (2005) Comparison of endovenous treatment with an 810 nm laser versus conventional stripping of the great saphenous vein in patients with primary varicose veins. Dermatol Surg 31:1685–1694PubMed
12.
Zurück zum Zitat Darwood RJ, Theivacumar N, Dellagrammaticas D et al (2008) Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins. Br J Surg 95:294–301PubMedCrossRef Darwood RJ, Theivacumar N, Dellagrammaticas D et al (2008) Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins. Br J Surg 95:294–301PubMedCrossRef
13.
Zurück zum Zitat Darwood RJ, Gough MJ (2009) Endovenous laser treatment for uncomplicated varicose veins. Phlebology 24(Suppl 1):50–61PubMedCrossRef Darwood RJ, Gough MJ (2009) Endovenous laser treatment for uncomplicated varicose veins. Phlebology 24(Suppl 1):50–61PubMedCrossRef
14.
Zurück zum Zitat Desmyttère J, Grard C, Wassmer B, Mordon S (2007) Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg 46:1242–1247PubMedCrossRef Desmyttère J, Grard C, Wassmer B, Mordon S (2007) Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg 46:1242–1247PubMedCrossRef
15.
Zurück zum Zitat Disselhoff BCVM, Kinderen DJ der, Kelder JC, Moll FL (2008) Randomized clinical trial comparing endovenous laser with cryostripping for great saphenous varicose veins. Br J Surg 95:1232–1238PubMedCrossRef Disselhoff BCVM, Kinderen DJ der, Kelder JC, Moll FL (2008) Randomized clinical trial comparing endovenous laser with cryostripping for great saphenous varicose veins. Br J Surg 95:1232–1238PubMedCrossRef
16.
Zurück zum Zitat Disselhoff BCVM, Kinderen DJ der, Kelder JC, Moll FL (2008) Randomized clinical trial comparing endovenous laser of the great saphenous varicose vein with and without ligation of the sapheno-femoral junction: 2-year resuls. Eur J Vasc Endovasc Surg 36:713–718PubMedCrossRef Disselhoff BCVM, Kinderen DJ der, Kelder JC, Moll FL (2008) Randomized clinical trial comparing endovenous laser of the great saphenous varicose vein with and without ligation of the sapheno-femoral junction: 2-year resuls. Eur J Vasc Endovasc Surg 36:713–718PubMedCrossRef
17.
Zurück zum Zitat Disselhof BCVM, Kinderen DJ der, Kelder JC, Moll FL (2011) Five-year results of a randomized clinical trial comparing endovenous laser ablation with cryostripping for great saphenous varicose veins. Br J Surg 98:1107–1111CrossRef Disselhof BCVM, Kinderen DJ der, Kelder JC, Moll FL (2011) Five-year results of a randomized clinical trial comparing endovenous laser ablation with cryostripping for great saphenous varicose veins. Br J Surg 98:1107–1111CrossRef
18.
Zurück zum Zitat Doganci S, Demirkilic U (2010) Comparison of 980 nm laser and bare-tip fibre with 1470 nm laser and radial fibre in the treatment of great saphenous vein varicosities: a prospective randomised clinical trial. Eur J Vasc Endovasc Surg 40:254–259PubMedCrossRef Doganci S, Demirkilic U (2010) Comparison of 980 nm laser and bare-tip fibre with 1470 nm laser and radial fibre in the treatment of great saphenous vein varicosities: a prospective randomised clinical trial. Eur J Vasc Endovasc Surg 40:254–259PubMedCrossRef
19.
Zurück zum Zitat Elmore FA, Lackey D (2008) Effectiveness of endovenous laser treatment in eliminating superficial venous reflux. Phlebology 23:21–31PubMedCrossRef Elmore FA, Lackey D (2008) Effectiveness of endovenous laser treatment in eliminating superficial venous reflux. Phlebology 23:21–31PubMedCrossRef
20.
Zurück zum Zitat Flessenkämper I, Hartmann M, Stenger D, Roll S (2013) Endovenous laser ablation with and without high ligation compared with high ligation and stripping in the treatment of great saphenous varicose veins: initial results of a multicentre randomized controlled trial. Phlebology 28:16–23PubMed Flessenkämper I, Hartmann M, Stenger D, Roll S (2013) Endovenous laser ablation with and without high ligation compared with high ligation and stripping in the treatment of great saphenous varicose veins: initial results of a multicentre randomized controlled trial. Phlebology 28:16–23PubMed
21.
Zurück zum Zitat Flessenkämper I, Stenger D, Hartmann M, Roll S (2013) Endoluminale Lasertherapie vs. Crossektomie/Stripping bei Vena saphena magna Varicosis – Klinische und sonographische Ergebnisse. Phlebologie 42:7–11CrossRef Flessenkämper I, Stenger D, Hartmann M, Roll S (2013) Endoluminale Lasertherapie vs. Crossektomie/Stripping bei Vena saphena magna Varicosis – Klinische und sonographische Ergebnisse. Phlebologie 42:7–11CrossRef
22.
Zurück zum Zitat Gale SS, Lee JN, Walsh ME et al (2010) A randomized, controlled trial of endovenous thermal ablation using the 810-nm wavelength laser and the ClosurePLUS radiofrequency ablation methods for superficial venous insufficiency of the great saphenous vein. J Vasc Surg 52:645–650PubMedCrossRef Gale SS, Lee JN, Walsh ME et al (2010) A randomized, controlled trial of endovenous thermal ablation using the 810-nm wavelength laser and the ClosurePLUS radiofrequency ablation methods for superficial venous insufficiency of the great saphenous vein. J Vasc Surg 52:645–650PubMedCrossRef
23.
Zurück zum Zitat Gloviczki P, Comerota AJ, Dalsing MC et al (2011) The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 53(Suppl):2S–48SPubMedCrossRef Gloviczki P, Comerota AJ, Dalsing MC et al (2011) The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 53(Suppl):2S–48SPubMedCrossRef
24.
Zurück zum Zitat Goode SD, Chowdhury A, Crockett M et al (2010) Laser and radiofrequency ablation study (LARA study): a randomised study comparing radiofrequency ablation and endovenous laser ablation (810 nm). Eur J Vasc Endovasc Surg 40:246–253PubMedCrossRef Goode SD, Chowdhury A, Crockett M et al (2010) Laser and radiofrequency ablation study (LARA study): a randomised study comparing radiofrequency ablation and endovenous laser ablation (810 nm). Eur J Vasc Endovasc Surg 40:246–253PubMedCrossRef
25.
Zurück zum Zitat Harlander-Locke M, Jimenez JC, Lawrence PF et al (2013) Management of endovenous heat-induced thrombus using classification system and treatment algorithm following segmental thermal ablation of the small saphenous vein. J Vasc Surg 58:427–432PubMedCrossRef Harlander-Locke M, Jimenez JC, Lawrence PF et al (2013) Management of endovenous heat-induced thrombus using classification system and treatment algorithm following segmental thermal ablation of the small saphenous vein. J Vasc Surg 58:427–432PubMedCrossRef
26.
Zurück zum Zitat Kalteis M, Berger I, Messie-Werndl S et al (2008) High ligation combined with stripping and endovenous laser ablation of the great saphenous vein: early results of a randomized controlled study. J Vasc Surg 47:822–829PubMedCrossRef Kalteis M, Berger I, Messie-Werndl S et al (2008) High ligation combined with stripping and endovenous laser ablation of the great saphenous vein: early results of a randomized controlled study. J Vasc Surg 47:822–829PubMedCrossRef
27.
Zurück zum Zitat Lawrence PF, Chandra A, Wu M et al (2010) Classification of proximal endovenous closure levels and treatment algorithm. J Vasc Surg 52:388–393PubMedCrossRef Lawrence PF, Chandra A, Wu M et al (2010) Classification of proximal endovenous closure levels and treatment algorithm. J Vasc Surg 52:388–393PubMedCrossRef
28.
Zurück zum Zitat Leopardi D, Hoggan BL, Fitridge RA et al (2009) Systematic review of treatments for varicose veins. Ann Vasc Surg 23:264–276PubMedCrossRef Leopardi D, Hoggan BL, Fitridge RA et al (2009) Systematic review of treatments for varicose veins. Ann Vasc Surg 23:264–276PubMedCrossRef
29.
Zurück zum Zitat Luebke T, Brunkwall J (2008) Systematic review and meta-analysis of endovenous radiofrequency obliteration, endovenous laser therapy and foam sclerotherapy for primary varicosis. J Cardiovasc Surg (Torino) 49:213–233 Luebke T, Brunkwall J (2008) Systematic review and meta-analysis of endovenous radiofrequency obliteration, endovenous laser therapy and foam sclerotherapy for primary varicosis. J Cardiovasc Surg (Torino) 49:213–233
30.
Zurück zum Zitat Lynch NP, Clarke M, Fulton GJ (2014) Surgical management of great saphenous vein varicose veins: a meta-analysis. Vascular (Epub ahead of print) Lynch NP, Clarke M, Fulton GJ (2014) Surgical management of great saphenous vein varicose veins: a meta-analysis. Vascular (Epub ahead of print)
31.
Zurück zum Zitat Marsh P, Price BA, Holdstock J et al (2010) Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre. Eur J Vasc Endovasc 40:521–527CrossRef Marsh P, Price BA, Holdstock J et al (2010) Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre. Eur J Vasc Endovasc 40:521–527CrossRef
32.
Zurück zum Zitat Min RJ, Khilnani NM (2005) Endovenous laser ablation of varicose veins. J Cardiovasc Surg 46:395–405 Min RJ, Khilnani NM (2005) Endovenous laser ablation of varicose veins. J Cardiovasc Surg 46:395–405
33.
Zurück zum Zitat Mundy L, Merlin TL, Fitridge RA, Hiller JE (2005) Systematic review of endovenous laser treatment for varicose veins. Br J Surg 92:1189–1194PubMedCrossRef Mundy L, Merlin TL, Fitridge RA, Hiller JE (2005) Systematic review of endovenous laser treatment for varicose veins. Br J Surg 92:1189–1194PubMedCrossRef
34.
Zurück zum Zitat Navarro L, Min RJ, Bone C (2001) Endovenous laser: a new minimally invasive method of treatment for varicose veins-preliminary observations using an 810 nm diode laser. Dermatol Surg 27:117–122PubMed Navarro L, Min RJ, Bone C (2001) Endovenous laser: a new minimally invasive method of treatment for varicose veins-preliminary observations using an 810 nm diode laser. Dermatol Surg 27:117–122PubMed
35.
Zurück zum Zitat Nesbitt C, Eifell RK, Coyne P et al (2011) Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices. Cochrane Database Syst Rev 10:CD005624PubMed Nesbitt C, Eifell RK, Coyne P et al (2011) Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices. Cochrane Database Syst Rev 10:CD005624PubMed
36.
Zurück zum Zitat Nesbitt C, Bedenis R, Bhattacharya V, Stansby G (2014) Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for great saphenous vein varices. Chochrane Database Syst Rev 7:CD005624 Nesbitt C, Bedenis R, Bhattacharya V, Stansby G (2014) Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for great saphenous vein varices. Chochrane Database Syst Rev 7:CD005624
37.
Zurück zum Zitat NICE National Institute for Health and Care Excellence (2013) Varicose veins in legs – the diagnosis and management of varicose veins in legs. NICE clinical guideline 168 guidance.nice.org.uk/cg168 NICE National Institute for Health and Care Excellence (2013) Varicose veins in legs – the diagnosis and management of varicose veins in legs. NICE clinical guideline 168 guidance.nice.org.uk/cg168
38.
Zurück zum Zitat Noppeney T, Kluess HG, Breu FX et al (2010) Leitlinie zur Diagnostik und Therapie der Krampfadererkrankung. Gefässchirurgie 15:523–541CrossRef Noppeney T, Kluess HG, Breu FX et al (2010) Leitlinie zur Diagnostik und Therapie der Krampfadererkrankung. Gefässchirurgie 15:523–541CrossRef
39.
Zurück zum Zitat Nordon IM, Hinchliffe RJ, Brar R et al (2011) A prospective double-blind randomized controlled trial of radiofrequency versus laser treatment of the great saphenous vein in patients with varicose veins. Ann Surg 254:876–881PubMedCrossRef Nordon IM, Hinchliffe RJ, Brar R et al (2011) A prospective double-blind randomized controlled trial of radiofrequency versus laser treatment of the great saphenous vein in patients with varicose veins. Ann Surg 254:876–881PubMedCrossRef
40.
Zurück zum Zitat Nwaejike N, Srodon PD, Kyriakides C (2009) 5-years of endovenous laser ablation (EVLA) for the treatment of varicose veins – a prospective study. Int J Surg 7:347–349PubMedCrossRef Nwaejike N, Srodon PD, Kyriakides C (2009) 5-years of endovenous laser ablation (EVLA) for the treatment of varicose veins – a prospective study. Int J Surg 7:347–349PubMedCrossRef
41.
Zurück zum Zitat Pan Y, Zhao J, Mei J et al (2014) Comparison of endovenous laser ablation and high ligation and stripping for varicose vein treatment: a meta-analysis. Phlebology 29:109–119PubMedCrossRef Pan Y, Zhao J, Mei J et al (2014) Comparison of endovenous laser ablation and high ligation and stripping for varicose vein treatment: a meta-analysis. Phlebology 29:109–119PubMedCrossRef
42.
Zurück zum Zitat Pannier F, Rabe E, Maurins U (2009) First results with a new 1470 nm diode laser for endovenous ablation of incompetent saphenous veins. Phlebology 24:26–30PubMedCrossRef Pannier F, Rabe E, Maurins U (2009) First results with a new 1470 nm diode laser for endovenous ablation of incompetent saphenous veins. Phlebology 24:26–30PubMedCrossRef
43.
Zurück zum Zitat Pannier F, Rabe E, Rits J et al (2011) Endovenous laser ablation of great saphenous veins using a 1470 nm diode laser and the radial fibre – follow up after six months. Phlebology 26(1):35–39PubMedCrossRef Pannier F, Rabe E, Rits J et al (2011) Endovenous laser ablation of great saphenous veins using a 1470 nm diode laser and the radial fibre – follow up after six months. Phlebology 26(1):35–39PubMedCrossRef
44.
Zurück zum Zitat Pavlovic MD, Schuller-Petrovic S, Pichot O et al (2014) Guidelines of the First International Consensus Conference on Endovenous Thermal Ablation for Varicose Vein Disease – ETAV Consensus Meeting 2012. Phlebology (Epub ahead of print) Pavlovic MD, Schuller-Petrovic S, Pichot O et al (2014) Guidelines of the First International Consensus Conference on Endovenous Thermal Ablation for Varicose Vein Disease – ETAV Consensus Meeting 2012. Phlebology (Epub ahead of print)
45.
Zurück zum Zitat Pronk P, Gauw SA, Mooij MC et al (2010) Randomised controlled trial comparing sapheno-femoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia. Eur J Vasc Endovasc Surg 40:649–656PubMedCrossRef Pronk P, Gauw SA, Mooij MC et al (2010) Randomised controlled trial comparing sapheno-femoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia. Eur J Vasc Endovasc Surg 40:649–656PubMedCrossRef
46.
Zurück zum Zitat Rasmussen LH, Bjoern L, Lawaetz M et al (2007) Randomized trial comparing endovenous laser ablation of the great saphenous vein with high ligation and stripping in patients with varicose veins: short-term results. J Vasc Surg 46:308–315PubMedCrossRef Rasmussen LH, Bjoern L, Lawaetz M et al (2007) Randomized trial comparing endovenous laser ablation of the great saphenous vein with high ligation and stripping in patients with varicose veins: short-term results. J Vasc Surg 46:308–315PubMedCrossRef
47.
Zurück zum Zitat Rasmussen LH, Bjoern L, Lawaetz M et al (2010) Randomized clinical trial comparing endovenous laser ablation with stripping of the great saphenous vein: clinical outcome and recurrence after 2 years. Eur J Vasc Endovasc Surg 39:630–635PubMedCrossRef Rasmussen LH, Bjoern L, Lawaetz M et al (2010) Randomized clinical trial comparing endovenous laser ablation with stripping of the great saphenous vein: clinical outcome and recurrence after 2 years. Eur J Vasc Endovasc Surg 39:630–635PubMedCrossRef
48.
Zurück zum Zitat Rasmussen LH, Lawaetz M, Bjoern L et al (2011) Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg 98:1079–1087PubMedCrossRef Rasmussen LH, Lawaetz M, Bjoern L et al (2011) Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg 98:1079–1087PubMedCrossRef
49.
Zurück zum Zitat Rasmussen LH, Lawaetz M, Bjoern L et al (2013) Randomized trial comparing endovenous laser ablation and stripping of the great saphenous vein with clinical and duplex outcome after 5 years. J Vasc Surg 58:421–426PubMedCrossRef Rasmussen LH, Lawaetz M, Bjoern L et al (2013) Randomized trial comparing endovenous laser ablation and stripping of the great saphenous vein with clinical and duplex outcome after 5 years. J Vasc Surg 58:421–426PubMedCrossRef
50.
Zurück zum Zitat Rass K, Frings N, Glowacki P et al (2012) Comparable effectiveness of endovenous laser ablation and high ligation with stripping of the great saphenous vein – two year results of a randomized clinical trial (RELACS Study). Arch Dermatol 148:49–58PubMedCrossRef Rass K, Frings N, Glowacki P et al (2012) Comparable effectiveness of endovenous laser ablation and high ligation with stripping of the great saphenous vein – two year results of a randomized clinical trial (RELACS Study). Arch Dermatol 148:49–58PubMedCrossRef
51.
Zurück zum Zitat Ravi R, Trayler EA, Barrett DA, Diethrich EB (2009) Endovenous thermal ablation of superficial venous insufficiency of the lower extremity: single-center experience with 3000 limbs treated in a 7-year period. J Endovasc Ther 16:500–505PubMedCrossRef Ravi R, Trayler EA, Barrett DA, Diethrich EB (2009) Endovenous thermal ablation of superficial venous insufficiency of the lower extremity: single-center experience with 3000 limbs treated in a 7-year period. J Endovasc Ther 16:500–505PubMedCrossRef
52.
Zurück zum Zitat Samuel N, Carradice D, Wallace T et al (2013) Randomized clinical trial of endovenous laser ablation versus conventional surgery for small saphenous varicose veins. Ann Surg 257:419–426PubMedCrossRef Samuel N, Carradice D, Wallace T et al (2013) Randomized clinical trial of endovenous laser ablation versus conventional surgery for small saphenous varicose veins. Ann Surg 257:419–426PubMedCrossRef
53.
Zurück zum Zitat Schmedt CG, Steckmeier BM (2006) Endoluminale Radiofrequenz- und Lasertherapie zur Therapie der Stammveneninsuffizienz. In: Marshall M, Breu FX (Hrsg) Handbuch der Angiologie EcoMed Medizin, Landsberg, 15. Erg.-Lfg. 12/06 S 1–28 Schmedt CG, Steckmeier BM (2006) Endoluminale Radiofrequenz- und Lasertherapie zur Therapie der Stammveneninsuffizienz. In: Marshall M, Breu FX (Hrsg) Handbuch der Angiologie EcoMed Medizin, Landsberg, 15. Erg.-Lfg. 12/06 S 1–28
54.
Zurück zum Zitat Schmedt CG, Sroka R, Steckmeier S et al (2006) Investigation on radiofrequency and laser (980 nm) effects after endoluminal treatment of saphenous vein insufficiency in an ex-vivo model. Eur J Vasc Endovasc Surg 32:318–325PubMedCrossRef Schmedt CG, Sroka R, Steckmeier S et al (2006) Investigation on radiofrequency and laser (980 nm) effects after endoluminal treatment of saphenous vein insufficiency in an ex-vivo model. Eur J Vasc Endovasc Surg 32:318–325PubMedCrossRef
55.
Zurück zum Zitat Schmedt CG, Meissner OA, Hunger K et al (2007) Evaluation of endovenous radiofrequency ablation and laser therapy with endoluminal optical coherence tomography in an ex vivo model. J Vasc Surg 45:1047–1058PubMedCrossRef Schmedt CG, Meissner OA, Hunger K et al (2007) Evaluation of endovenous radiofrequency ablation and laser therapy with endoluminal optical coherence tomography in an ex vivo model. J Vasc Surg 45:1047–1058PubMedCrossRef
56.
Zurück zum Zitat Schmedt CG, Sroka R, Steckmeier S et al (2010) Endovenöse Laser-Ablation. In: Noppeney T, Nüllen H (Hrsg) Varikose. Diagnostik – Therapie – Begutachtung. Springer, Berlin Heidelberg New York Tokio Schmedt CG, Sroka R, Steckmeier S et al (2010) Endovenöse Laser-Ablation. In: Noppeney T, Nüllen H (Hrsg) Varikose. Diagnostik – Therapie – Begutachtung. Springer, Berlin Heidelberg New York Tokio
57.
Zurück zum Zitat Schmedt CG, Sroka R, Sadeghi M et al (2010) Neue Entwicklungen der endovenösen Lasertherapie. Gefässchirurgie 15:125–132CrossRef Schmedt CG, Sroka R, Sadeghi M et al (2010) Neue Entwicklungen der endovenösen Lasertherapie. Gefässchirurgie 15:125–132CrossRef
58.
Zurück zum Zitat Schwarz T, Hodenberg E von, Furtwängler C et al (2010) Endovenous laser ablation of varicose veins with the 1470 nm diode laser. J Vasc Surg 51:1474–1478PubMedCrossRef Schwarz T, Hodenberg E von, Furtwängler C et al (2010) Endovenous laser ablation of varicose veins with the 1470 nm diode laser. J Vasc Surg 51:1474–1478PubMedCrossRef
59.
Zurück zum Zitat Shepherd AC, Gohel MS, Brown LC et al (2010) Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins. Br J Surg 97:810–818PubMedCrossRef Shepherd AC, Gohel MS, Brown LC et al (2010) Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins. Br J Surg 97:810–818PubMedCrossRef
60.
Zurück zum Zitat Siribumrungwong B, Noorit P, Wilasrusmee C et al (2012) A systematic review and meta-analysis of randomised controlled trials comparing endovenous ablation and surgical intervention in patients with varicose vein. Eur J Vasc Endovasc Surg 44:214–223PubMedCrossRef Siribumrungwong B, Noorit P, Wilasrusmee C et al (2012) A systematic review and meta-analysis of randomised controlled trials comparing endovenous ablation and surgical intervention in patients with varicose vein. Eur J Vasc Endovasc Surg 44:214–223PubMedCrossRef
61.
Zurück zum Zitat Sroka R, Weick K, Sadeghi-Azandaryani M et al (2010) Endovenous laser therapy – application studies and latest investigations. J Biophotonics 3:269–276PubMedCrossRef Sroka R, Weick K, Sadeghi-Azandaryani M et al (2010) Endovenous laser therapy – application studies and latest investigations. J Biophotonics 3:269–276PubMedCrossRef
62.
Zurück zum Zitat Sroka R, Weick K, Steckmaier S et al (2012) The ox-foot-model for investigating endoluminal thermal treatment modalities of varicosis vein diseases. ALTEX 29:403–410PubMedCrossRef Sroka R, Weick K, Steckmaier S et al (2012) The ox-foot-model for investigating endoluminal thermal treatment modalities of varicosis vein diseases. ALTEX 29:403–410PubMedCrossRef
63.
Zurück zum Zitat Sroka R, Pongratz T, Siegrist K et al (2013) Endovenous laser application. Strategies to improve endoluminal energy application. Phlebology 42:121–129CrossRef Sroka R, Pongratz T, Siegrist K et al (2013) Endovenous laser application. Strategies to improve endoluminal energy application. Phlebology 42:121–129CrossRef
64.
Zurück zum Zitat Sroka R, Hemmerich M, Pongratz T et al (2013) Endovenous laser application. Possibilities of online monitoring. Phlebology 42:131–138CrossRef Sroka R, Hemmerich M, Pongratz T et al (2013) Endovenous laser application. Possibilities of online monitoring. Phlebology 42:131–138CrossRef
65.
Zurück zum Zitat Viarengo LM, Potério-Filho J, Potério GM et al (2007) Endovenous laser treatment for varicose veins in patients with active ulcers: measurement of intravenous and perivenous temperatures during the procedure. Dermatol Surg 33:1234–1242PubMed Viarengo LM, Potério-Filho J, Potério GM et al (2007) Endovenous laser treatment for varicose veins in patients with active ulcers: measurement of intravenous and perivenous temperatures during the procedure. Dermatol Surg 33:1234–1242PubMed
66.
Zurück zum Zitat Vuylsteke M, Bo TH de, Dompe G et al (2011) Endovenous laser treatment: is there a clinical difference between using 1500 nm and a 980 nm diode laser? A multicenter randomized clinical trial. Int Angiol 30:327–334PubMed Vuylsteke M, Bo TH de, Dompe G et al (2011) Endovenous laser treatment: is there a clinical difference between using 1500 nm and a 980 nm diode laser? A multicenter randomized clinical trial. Int Angiol 30:327–334PubMed
67.
Zurück zum Zitat Bos R van den, Arends L, Kockaert M et al (2009) Endovenous therapies of lower extremity varicosities: a meta-analysis. J Vasc Surg 49:230–239PubMedCrossRef Bos R van den, Arends L, Kockaert M et al (2009) Endovenous therapies of lower extremity varicosities: a meta-analysis. J Vasc Surg 49:230–239PubMedCrossRef
68.
Zurück zum Zitat Bos RR van den, Malskat WSJ, Maesener MGR de et al (2014) Randomized clinical trial of endovenous laser ablation versus steam ablation (LAST trial) for great saphenous varicose veins. Br J Surg 101:1077–1083PubMedCrossRef Bos RR van den, Malskat WSJ, Maesener MGR de et al (2014) Randomized clinical trial of endovenous laser ablation versus steam ablation (LAST trial) for great saphenous varicose veins. Br J Surg 101:1077–1083PubMedCrossRef
69.
Zurück zum Zitat Hodenberg E von, Zerweck C, Knittel M et al (2013) Endovenous laser ablation of varicose veins with the 1470 nm diode laser using a radial fibre – 1 year follow up. Phlebology (Epub ahead of print) Hodenberg E von, Zerweck C, Knittel M et al (2013) Endovenous laser ablation of varicose veins with the 1470 nm diode laser using a radial fibre – 1 year follow up. Phlebology (Epub ahead of print)
70.
Zurück zum Zitat Zerweck C, Hodenberg E von, Knittel M et al (2014) Endovenous laser ablation of varicose perforating veins with the 1470 nm diode laser using the radial fibre slim. Phlebology 29:30–36PubMed Zerweck C, Hodenberg E von, Knittel M et al (2014) Endovenous laser ablation of varicose perforating veins with the 1470 nm diode laser using the radial fibre slim. Phlebology 29:30–36PubMed
Metadaten
Titel
Endovenöse Lasertherapie der Varikose – Evidenz und Perspektiven
verfasst von
PD Dr. C.-G. Schmedt
S. Dikic
A. Esipova
S. Demhasaj
T. Küspert
R. Sroka
Publikationsdatum
01.11.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Gefässchirurgie / Ausgabe 7/2014
Print ISSN: 0948-7034
Elektronische ISSN: 1434-3932
DOI
https://doi.org/10.1007/s00772-014-1355-5

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