Varicose vein surgery has come a long way in recent years, with laser thermal ablation (EVLA) and radiofrequency (RFA) techniques considered to be the gold standard. New-generation lasers have been introduced with higher wavelengths, such as 1940 and 2000 nm, which have a greater affinity for water than the old generation (980- and 1470-nm lasers).
In a recent study by Luca Palombi, Monica Morelli, Dario Bruzzese, and Gennaro Quarto, published on PubMed, the biological effects of different laser wavelengths were evaluated. The aim was to assess the biological effect and the temperatures produced during the use of lasers with different wavelengths (980, 1470, and 1940 nm) and optical fibers with different emission on an in vitro model of porcine liver.
The study found that the 1470-nm and 1940-nm lasers, regardless of the type of fiber used, produced no statistically significant differences in the maximum transverse diameter (DTM) of the lesion produced on the target tissue. On the other hand, the 980-nm laser produced no visible effect on the model. Additionally, when comparing the temperatures developed during and immediately after the treatment, the 980-nm laser showed higher maximum surface temperatures (TSM) and a higher thermal increase (IT) compared to the 1940-nm laser, regardless of the type of fiber used, in a statistically significant way.
However, when comparing the 980-nm laser with the 1470-nm laser, there were no differences in TI recorded during the procedure, but a significantly higher VTI was observed.
This study shows that new-generation lasers, compared with those of the first and second generation, work overall at lower temperatures with the same effectiveness. As such, it is important for phlebologists to understand the biological effects of different laser wavelengths and choose the appropriate laser and fiber for each patient to ensure the best possible outcomes.
In conclusion, this study sheds light on the biological effects of different laser wavelengths in varicose vein surgery. The 1470-nm and 1940-nm lasers are shown to be equally effective, while the 980-nm laser produces higher temperatures and a higher thermal increase. Phlebologists should keep this in mind when selecting the appropriate laser and fiber for each patient, as it can impact the patient’s outcome.
