Histological Difference between Pulse Wave Mode and Continuous Mode of Endovenous Laser Ablation Kansaku R 1,2,4, Sakakibara N 1,2,4, Shimabukuro T 2,

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Histological Difference between Pulse Wave Mode and Continuous Mode of Endovenous Laser Ablation Kansaku R 1,2,4, Sakakibara N 1,2,4, Shimabukuro T 2, Endo H 3, Amano A 4, Iwamura T 4, Sueishi M 4, Matsumoto T 5 Edogawa Vein Center 1, The Departments of Cardiovascular Surgery 2 and Pathology 3,Edogawa Hospital, The Departments of Cardiovascular Surgery 4 and Pathology 5, Juntendo University Rev. A

Background The results of EVLA are affected by… the linear endovenous energy density (LEED) the endovenous fluence equivalent (EFE). The difference after EVLA using continuous wave laser (CW) and pulsed wave laser (PW) is unclear. We demonstrated the histological change in venous walls following EVLA using CW and PW at various energy settings. 1

Methods-1 Great Saphenous Vein 2 Saline Pull Back Fiber Blood

Methods-2 3 Device PowerFrequencyVelocityLEED Pulse Length Peak Power WHzmm/secJ/cmμsecW 1)980 CW ) 1470 CW ) ) 1320 PW ) ) ) )

Results-1 980CW1470 CW1320 PW 10W 1.4mm/sec 6W 0.5mm/sec 6W 1.0 mm/sec 6W, 40Hz, 1.0 mm/sec, 350μsec 6W, 50Hz, 1.0 mm/sec, 350μsec 12W, 40Hz, 2.0 mm/sec, 300μsec 15W, 40Hz, 2.0 mm/sec, 300μsec 18W, 40Hz, 2.0 mm/sec, 300μsec 4

Results 5 Device PowerFreqLEEDNumbers WHzJ/cmUlcerPerforationSpecimens 1)980 CW (27%)11 (73%)15 2) 1470 CW (67%)1 (33%)3 3) (50%) 4 4) 1320 PW ) ) ) )

Histological Change after EVLA EVLA using Continuous Wave Collagen Denaturing / Bilateral Chaarring / Ablation / Perforation Carbonization / Homogeneous basophilic discoloration / Coaglation necrosis and loss of distinction between collagen and muscular bundles EVLA using Pulsed Wave Not revealed yet 6 der Kinderen DJB. Dermatol Surg 2009;35:12: Fan CM and Rox-Anderson R. Phlebology 2008;23:5:

Typical Changes after EVLA PreCWPW 7

Conclusion 8 Tokyo Sky Tree