Year 2013 Vol. 21 No 2

GENERAL AND SPECIAL SURGERY

E.V. SHAYDAKOV1, V.L. BULATOV1,2, Å.À. ILYUKHIN3, I.N. SONKIN4, A.G. GRIGORYAN1

PREDICTION OF RESULTS AT ENDOVENOUS LASER ABLATION IN PATIENTS OF DIFFERENT AGE GROUPS

FSBE “SII of Experimental Medicine” of the North-west district of RAMS1,
Saint-Petersburg Institute of Bioregulation and Gerontology of the North-west district of RAMS 2,
Clinic “Medalp” 3,
Railway clinical hospital of JSC “Russian railways” 4, Saint-Petersburg
The Russian Federation

Objectives. To work out the prognostic models of results at endovenous laser ablation (EVLA) to treat varicose veins according to the combined ultimate point taking into account the patient’s age on the basis of clinical data of the retrospective cohort multicentre study (RCMS).
Methods. The research was conducted using the data of the retrospective linear cohort multicentre study on the basis of the vascular departments of three specialized clinics of Saint-Petersburg during the period from January, 2010 up to May, 2011. 257 patients with varicose veins of Ñ2 – Ñ3 classes of clinical manifestation according to ÑÅÀÐ were included in the study. The patients were subdivided into 2 cohorts: laser with the wave length of 970 nm was applied in the “H” cohort; 1470 nm and 1560 nm – in “W” cohort. The evaluation was done according to the combined ultimate point including three components: pain, ecchymosis, the presence of recanalization of the great saphenous vein (GSV) in the middle third of the thigh. The results were divided into 4 groups: the best, good, bad and the worst one. Mathematical-statistic packet of the applied programs KNIME (The Konstanz Information Miner), KNIME Desktop, version 2. 6.0 was used for calculations.
Results. The model of the results’ prediction of EVLA for different age groups was designed according to general selection and in case of lasers H and W application.
Conclusions. At W-laser application better results of EVLA are predicted in elderly and senile patients than in young patients. In case of H-laser application the result doesn’t depend on the age. Range of the linear endovenous energy density (LEED) and the diameter of veins influencing the treatment results are wider for W-laser than for H-laser in all age groups. Maximal difference of EVLA H- and W-lasers results regardless of age were revealed in the range of the vein diameters of 8-10 mm that are seen in greater frequency of obtaining the best results at W-laser application.

Keywords: primary varicose veins, endovenous laser ablation, H-laser, W-laser, prediction of resultss
p. 61 – 68 of the original issue
References
  1. Navarro L, Min RJ, Bone C. Endovenous laser: a new minimally invasive method of treatment for varicose veins-preliminary observations using an 810 nm diode laser. Dermatol Surg. 2001 Feb;27(2):117–22.
  2. Siribumrungwong B, Noorit P, Wilasrusmee C, Attia J, Thakkinstian A. 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. 2012 Aug;44(2):214–23.
  3. Shevchenko IuL, Stoiko IuM, Mazaishvili KV, Khlevtova TV. Mekhanizm endovenoznoi lazernoi obliteratsii: novyi vzgliad [The mechanism of endovenous laser ablation: a new look]. Flebologiia. 2011;5(1):46–50.
  4. Timperman PE, Sichlau M, Ryu RK. Greater energy delivery improves treatment success of endovenous laser treatment of incompetent saphenous veins. J Vasc Interv Radiol. 2004 Oct;15(10):1061–63.
  5. Proebstle TM, Krummenauer F, Gul D, Knop J. Nonocclusion and early reopening of the great saphenous vein after endovenous laser treatment is fluence dependent. Dermatol Surg. 2004 Feb;30(2 Pt 1):174–78.
  6. Min RJ, Khilnani NM. Endovenous laser ablation of varicose veins. J Cardiovasc Surg (Torino). 2005 Aug;46(4):395–405.
  7. Kaspar S, Siller J, Cervinkova Z, Danek T. Standardisation of parameters during endovenous laser therapy of truncal varicose veins--experimental ex-vivo study. Eur J Vasc Endovasc Surg. 2007 Aug;34(2):224–28.
  8. KNIME (Konstanz Information Miner). Available from: http://www.knime.org.
  9. Berthold MR, Cebron N, Dill F, Gabriel TR, Kotter T, Meinl T, Ohl P, Sieb C, Thiel K, Wiswedel B. KNIME: The Konstanz Information Miner. In Data Analysis, Machine Learning and Applications Proceedings of the 31st Annual Conference of the Gesellschaft fur Klassifikation. Berlin, Germany: Springer; 2007. p. 319–26.
  10. Shaidakov EV, Bulatov VL, Iliukhin EA, Son'kin IN, Grigorian AG, Gal'chenko MI. Optimal'nye rezhimy endovenoznoi lazernoi obliteratsii s dlinoi volny 970 nm, 1470 nm i 1560 nm: Retrospektivnoe prodol'noe kogortnoe issledovanie [Optimal conditions of endovenous laser ablation with 970 nm, 1470 nm and 1560 nm wavelength: a retrospective longitudinal cohort study]. Shaidakov EV, red. Sbornik tez 5 Saint-Petersburg Venoz foruma; 2012 Dek 7; Saint-Petersburg, RF. p. 85–86.
  11. Roggan A, Friebel M, Do Rschel K, Hahn A, Mu Ller G. Optical Properties of Circulating Human Blood in the Wavelength Range 400-2500 nm. J Biomed Opt. 1999 Jan;4(1):36–46.
  12. Disselhoff BC, Rem AI, Verdaasdonk RM, Kinderen DJ, Moll FL. Endovenous laser ablation: an experimental study on the mechanism of action. Phlebology. 2008 Jan;23(2):69–76.
  13. Sokolov AL, Liadov KV, Lutsenko MM, Lavrenko SV, Liubimova AA, Verbitskaia GO, Minaev VP. Primenenie lazernogo izlucheniia 1,56 mkm dlia endovazal'noi obliteratsii ven v lechenii varikoznoi bolezni [The use of laser radiation (1.56 micron) for endovasal ablation in the treatment of varicose veins]. Angiologiia i Sosud Khirurgiia. 2009;15(1):69–75.
  14. Proebstle T, Moehler T, Gul D, Herdemann S. Endovenous treatment of the great saphenous vein using a 1,320 nm Nd:YAG laser causes fewer side effects than using a 940 nm diode laser. Dermatol Surg. 2005 Dec;31(12):1678–83.
  15. Mordon SR, Wassmer B, Zemmouri J. Mathematical modeling of 980-nm and 1320-nm endovenous laser treatment. Lasers Surg Med. 2007 Mar;39(3):256–65.
Address for correspondence:
197376, Rossiiskaia Federatsiia, g. Sankt-Peterburg, ul. Akademika Pavlova, d. 12, FGBU «NII Eksperimental'noi Meditsiny» SZO RAMN,
e-mail:bulatovvas@gmail.com,
Bulatov Vasilii Leonidovich
Information about the authors:
Shaydakov E.V. MD, professor, deputy director of FSBE “SII of Experimental Medicine” of North-West District of RAMS, Saint-Petersburg.
Bulatov V.L. A researcher of the biogerontology laboratory of the Institute of bioregulation and gerontology of North-West District of RAMS, Saint-Petersburg.
Ilyukhin E.A. Chief physician of the clinic “Medalp”, Saint-Petersburg.
Sonkin I.N. PhD, a head of the vascular department of the railway clinical hospital JSC “Russian railways”, Saint-Petersburg.
Grigoryan A.G. Vascular surgeon of FSBE “SII of Experimental Medicine” of North-West District of RAMS, Saint-Petersburg.
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