Browsing by Author "Aktas, Aykut Recep"

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Comparing 1470-and 980-nm Diode Lasers for Endovenous Ablation Treatments
(2015) Aktas, Aykut Recep; Celik, Orhan; Ozkan, Ugur; Cetin, Mustafa; Koroglu, Mert; Yilmaz, Sevda; Daphan, Birsen U.; Oguzkurt, Levent; 0000-0002-3506-2039; 25990260
The purpose of this study was to compare the effectiveness of 1470- and 980-nm lasers with regard to power output, complications, recanalization rates, and treatment response. We prospectively evaluated the effectiveness of endovenous laser ablation (EVLA) in a total of 152 great and small saphenous veins from 96 patients. Lasers were randomly used based on the availability of the units. Patients were clinically evaluated for Clinical Etiologic Anatomic Pathophysiologic (CEAP) stage and examined with Doppler ultrasound. Treatment response was determined anatomically by occlusion of the vein and clinically by the change in the venous clinical severity score (VCSS). Seventy-eight of the saphenous veins underwent EVLA with a 980-nm laser and 74 underwent EVLA with a 1470-nm laser. Treatment response was (68) 87.2 % in the 980-nm group and (74) 100 % in the 1470-nm group (p = 0.004). The median VCSS decreased from 4 to 2 in the 980-nm group (p < 0.001) and from 8 to 2 (p < 0.001) in the 1470-nm group. At 1-year follow-up, seven veins treated with 980 nm and two veins treated with 1470 nm were recanalized (p = 0.16); the average linear endovenous energy density (LEED) was 83.9 (r, 55-100) J/cm and 58.5 (r, 45-115) J/cm, respectively (p < 0.001). Postoperative minor complications occurred in 23 (29.4 %) limbs in the 980-nm group and in 19 (25.6 %) limbs of the 1470-nm group (p = 0.73). EVLA with the 1470-nm laser have less energy deposition for occlusion and better treatment response.
Secondary Ablation of Saphenous Veins: The Reasons and The Ratios
(2016) Aktas, Aykut Recep; Ozkan, Ugur; 25883245
Objective To assess recurrence of saphenous veins and their tributaries following endovenous laser ablation (EVLA) and define primary or secondary ablation ratios as a result of misinterpretation, new incompetency formation, and re-canalization. Methods The EVLA procedure was applied for vein insufficiency to 50 symptomatic patients (range, 22-78 years; mean age 4514 years; gender, 18 [36%] men, and 32 [64%] women). Before and after the procedure, a total of 80 legs were prospectively evaluated for recanalization of the great and small saphenous vein, anterolateral, posteromedial, intersaphenous thigh, and the calf veins by Doppler ultrasonography. EVLA was performed on the saphenous veins along with their tributaries, andwas defined astheprimary ablation. EVLAand alcohol ablation after the first procedure was defined as the secondary ablation. We evaluated the veins according to re-canalization and secondary ablation, and also measured the primary and secondary ablation ratios. Results Seventy-three (97.0%) VSM and 39 (95.0%) VSP were treated with primary ablation and 2(3.0%) VSM and 2 (5.0%) VSP were treated with secondary ablation because of newly developed incompetency. In addition, 15 (71.0%) saphenous tributaries were treated with primary and 6 (29.0%) with secondary ablation. After primary or secondary ablation, 9 (12.0%) misinterpretation or new incompetency formation was found during a one-year follow-up. Seven (9.0%) VSM were re-canalized at the mean length of 46 +/- 15cm (range 32-65cm) in one year. The laser energy in the re-canalized VSM was 78 +/- 25 joules/cm (range 61-83) and all were retreated with laser or foam sclerotherapy. Conclusions VSM re-canalization and new vessel incompetency formation are reasons for secondary ablation, which is not a rare condition. Follow-up examinations and anatomical mapping are crucial for detecting new vessel formation or miss-interpretation after sclerotherapy or EVLA treatment.