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Optimization of endovenous laser coagulation: in vivo experiments

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Abstract

Finding optimal parameters of endovenous laser coagulation using the radiation with a wavelength of 1910 nm. In vivo experiments have been carried out on the small saphenous veins of three sheep of Edilbay breed and the dependence of venous wall and surrounding tissue damage on the radiation power was analyzed on the basis of morphological study results, as well as ultrasound examination and clinical observation of animals in the postoperative period. As radiation source, we used the diode-pumped solid-state laser, based on the LiYF4:Tm crystal, with emission wavelength of 1910 nm. For morphological study, veins were harvested immediately and 40 days after operation. Histological analysis of the vein after treatment with 1.5-W radiation revealed asymmetric wall injury and a thrombus formation in the lumen. The blood thrombus formation and pronounced vein wall damage was observed after treatment with 3-W radiation. Perivenous tissue injury is insignificant and does not lead to postoperative complications as in the case of using 1.5-W radiation. Increasing the radiation power to 4 W results in the total vein wall destruction and the thrombus formation, which persists for 40 days after the procedure. Based on the results of clinical observations of animals with registration of skin wound healing, as well as the results of histological examination of veins harvested immediately after the EVLC and 40 days after, it was concluded that the laser power value of 3–4 W can be recommended for use in the clinic.

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Funding

This research was supported by the Russian Foundation for Basic Research (Grant No. 18-29-20,039) and the Ministry of Education and Science of the Russian Federation (Project No. 1.4926.2017/6.7).

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Authors and Affiliations

  1. National Research Mordovia State University, 68 Bolshevistskaya Str, Saransk, 430005, Republic of Mordovia, Russia

    Sergey A. Artemov, Alexander N. Belyaev, Olga S. Bushukina, Svetlana A. Khrushchalina, Sergey V. Kostin, Andrey A. Lyapin, Polina A. Ryabochkina & Alina D. Taratynova

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  1. Sergey A. Artemov
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  2. Alexander N. Belyaev
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  3. Olga S. Bushukina
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  4. Svetlana A. Khrushchalina
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  5. Sergey V. Kostin
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  6. Andrey A. Lyapin
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  7. Polina A. Ryabochkina
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  8. Alina D. Taratynova
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Correspondence to Polina A. Ryabochkina.

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Conflict of interest

All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and have disclosed the following: Alexander N. Belyaev, Andrey A. Lyapin, and Polina A Ryabochkina have a patent “The method of laser obliteration of varicose veins.” Sergey A. Artemov, Alexander N. Belyaev, Svetlana A. Khruschalina, Andrey A. Lyapin, and Polina A. Ryabochkina report grants from Russian Foundation for Basic Research, during the conduct of the study. In addition, Polina A. Ryabochkina reports grant from the Ministry of Education and Science of the Russian Federation.

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Appendix 1. Macro- and microscopic parameters of the vein wall after EVLC

Appendix 1. Macro- and microscopic parameters of the vein wall after EVLC

Morphometric operations were performed using Sigma Scan Рго 5 software (SPSS Inc., USA). The narrowing degree of the vein lumen was determined by the ratio of the total wall thickness l to the vein radius d/2 as k = 2l/d. As this ratio decreases, lumen size increase.

Macro - and microscopic parameters of the vein wall after EVLC are presented in Table 1.

The table shows change in the morphometric parameters of the vein wall after EVLC depending on laser radiation power. After treatment by a radiation with power of 4 W, a vein wall thickness decreases due to total destruction, and the k value for the residual fragment exceeds the control value. After EVLC using radiation with a power of 3 W, an increase in the k value is observed, which indicates a significant thickening of the venous wall and a narrowing of the lumen. The effect of 1.5-W laser radiation on the vessel also led to wall thickening and narrowing of the vein lumen but to a lesser extent.

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Artemov, S.A., Belyaev, A.N., Bushukina, O.S. et al. Optimization of endovenous laser coagulation: in vivo experiments. Lasers Med Sci 35, 867–875 (2020). https://doi.org/10.1007/s10103-019-02874-6

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