ABSTRACT

The most common complication associated with laser treatment is paresthesia, which occurs in fewer than 10% of procedures. The goal of radiofrequency (RF) and laser ablation is to close incompetent pathologic perforator veins in order to reduce venous hypertension and promote wound healing. Treatment of incompetent perforating veins with RF and laser catheters is technically difficult and often has a steep learning curve, so ablation success is associated with surgeon experience and volume. The laser fiber is introduced into the perforator vein through the needle and tumescent anesthesia is injected along the course of the catheter, around the perforator vein. The laser fiber is slowly withdrawn to treat the entire length of the perforator vein. In patients with recanalization or initial technical failure, repeat RF or laser procedures were completed with nearly 100% closure rates. Current evidence supports both RF and laser as excellent tools for closing incompetent perforator veins, with nearly identical technical success and complication rates reported.