ABSTRACT
This chapter discusses primarily concern itself with endovenous laser ablation. Prior to the publication of single-center case series reports of endovenous laser ablation of the incompetent saphenous vein, no multicenter clinical trials of the safety and efficacy of this procedure in humans were published. Laser generators are available from various manufacturers, all of which appear to be effective at producing venous ablation. Lower-wavelength lasers target hemoglobin as the primary chromophore. Endovenous laser ablation was performed in the hospital surgical or radiologic suite under general anesthesia or conscious sedation. If incompetent, the distal portion of the great saphenous vein or small saphenous vein saphenous veins are often not treated with endovenous laser ablation because of the increased risk of paresthesia from damage to the saphenous or sural nerve, which is in close proximity to the vein distally. A micro-insertion set can be used to gain access, and the caliber of sheath “stepped up” to accommodate the laser fiber.
