Abstract
A 67-year-old woman was admitted to our institution with pain, night cramping, and visible varicose veins on her left leg. Doppler ultrasonography revealed continuous reflux in the great saphenous vein when the patient did the Valsalva maneuver. Endovenous laser therapy was applied to the great saphenous vein. Doppler ultrasonography 7 days later showed recanalization of, and arterialized flow in, the great saphenous vein. There also were small arterial vessels adjunct to the recanalized side. A left femoral angiography via a right femoral approach showed multiple small arteriovenous fistulas between superficial femoral artery muscle branches and the great saphenous vein. A second endovenous laser treatment was done at 80 J/cm, but the recanalization persisted. We offered to treat this endovascularly, but the patient preferred a surgical option. To the best of our knowledge, this is the first report of the demonstration of such a complication with endovenous laser therapy.
Similar content being viewed by others
References
Beebe-Dimmer JL, Pfeifer JR et al (2005) The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol 15(3):175–184
Teruya TH, Ballard JL (2004) New approaches for the treatment of varicose veins. Surg Clin North Am 84(5):1397–1417, viii–ix
Min RJ, Khilnani NM (2005) Endovenous laser ablation of varicose veins. J Cardiovasc Surg (Torino) 46(4):395–405
Labropoulos N, Bhatti A, Leon L et al (2006) Neovascularization after great saphenous vein ablation. Eur J Vasc Endovasc Surg 31(2):219–222
Timperman PE (2004) Arteriovenous fistula after endovenous laser treatment of the short saphenous vein. J Vasc Interv Radiol 15:625–627
Kim HS, Nwankwo IJ, Hong K et al (2006) Lower energy endovenous laser ablation of the great saphenous vein with 980 nm diode laser in continuous mode. Cardivasc Interv Radiol 29(1):64–69
Proebstle TM, Krummenauer F, Gül D et al (2004) Nonocclusion and early reopening of the great saphenous vein after endovenous laser treatment is fluence dependent. Dermatol Surg 30(2; Pt 1):174–178
Proebstle TM, Moehler T, Gül D et al (2005) Endovenous treatment of the great saphenous vein using a 1,320 nm Nd:YAG laser causes fewer side effects than using a 940 nm diode laser. Dermatol Surg 31(12):1678–1683; discussion 1683–1684
Timperman PE (2005) Prospective evaluation of higher energy great saphenous vein endovenous laser treatment. J Vasc Interv Radiol 16(6):791–794
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yildirim, E., Saba, T., Ozulku, M. et al. Treatment of an Unusual Complication of Endovenous Laser Therapy: Multiple Small Arteriovenous Fistulas Causing Complete Recanalization. Cardiovasc Intervent Radiol 32, 166–168 (2009). https://doi.org/10.1007/s00270-008-9356-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-008-9356-y