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[en] To assess outcomes after endovenous laser ablation (EVLA) of the small saphenous vein (SSV). Retrospective review was performed of all consecutive EVLA procedures performed over a 39-month period at three neighboring vein practices for symptomatic, duplex ultrasound-proven incompetence of the SSV. EVLA was performed under ultrasound guidance with an 810- or 980-nm diode laser in continuous mode using the pullback method while sparing the deep, most cephalad segment of the SSV near the saphenopopliteal junction. Follow-up after EVLA included patient symptoms, physical examination, and duplex ultrasound. Pretreatment variables were similar across all three practices. EVLA was performed to treat 67 incompetent SSVs in 63 patients (86% women; mean age and 95% confidence interval, 50 ± 3 years; range, 20-82 years). Average energy delivered was 92 J/cm. Immediate technical success and occlusion of the treated vein at 1-2 weeks was 100%. Imaging follow-up length was 243 ± 65 days (range, 3-893 days). Clinical follow-up (243 ± 66 days) showed symptomatic improvement in 66 (99%) of 67 patients; one patient had recanalization with recurrent reflux by ultrasound (2%). Complications included one case of paresthesias lasting beyond 1 month of follow-up (2%) and three cases of superficial phlebitis (4%), but no deep vein thrombosis, skin burns, or other complications. Although ablation involved only the superficial portion of the SSV and spared its deep segment in the popliteal fossa, SSV occlusion typically extended up to the saphenopopliteal junction or to a gastrocnemial collateral, without popliteal vein involvement. EVLA of the SSV is safe and effective when the saphenopopliteal junction and popliteal fossa are avoided. This approach may help reduce the risk of paresthesias or other complications while maintaining low recanalization rates.
[en] The aim of this study was to assess the feasibility of endovenous laser ablation of incompetent perforator veins in a patient with incompetency of the small saphenous vein and multiple perforator veins. Two different methods were used to ablate seven perforator veins with a laser giving 50-60 J/cm energy. Total occlusion was observed in six perforators, and partial ablation in one perforator, at 1-month follow-up. To our knowledge, endovenous laser ablation of incompetent perforator veins is easy and a good therapeutic method.
[en] Physical mechanisms and theoretical models of laser ablation are discussed. For various mechanisms, typical associated phenomena are qualitatively regarded and methods for studying them quantitatively are considered. Calculated results relevant to ablation kinetics for a number of substances are presented and compared with experimental data. (reviews of topical problems)
[en] The craters resulting from high-irradiance (1x109-1x1011 W/cm2) single-pulse laser ablation of single-crystal silicon show a dramatic increase in volume at a threshold irradiance of 2.2x1010 W/CM2. Time-resolved shadowgraph images show ejection of large particulates from the sample above this threshold irradiance, with a time delay ∼300 ns. A numerical model was used to estimate the thickness of a superheated layer near the critical state. Considering the transformation of liquid metal into liquid dielectric near the critical state (i.e., induced transparency), the calculated thickness of the superheated layer at a delay time of 200-300 ns agreed with the measured crater depths. This agreement suggests that induced transparency promotes the formation of a deep superheated layer, and explosive boiling within this layer leads to particulate ejection from the sample. (c) 2000 American Institute of Physics
[en] Highlights: • cTACE is an effective treatment option in patients with advanced non-resectable CRLM. • cTACE followed by percutaneous thermal ablation increases OS and PFS. • Extrahepatic metastases are a prognostic factor in the OS and PFS in cTACE therapy. • Hepatic tumor burden influences OS and PFS in neoadjuvant cTACE prior to ablation. • A triple combination of chemotherapeutics improves response to cTACE. - Abstract: PurposeTo determine overall (OS) and progression-free survival (PFS) for cTACE alone and in combination with percutaneous thermal ablation in patients with non-resectable, chemotherapy-resistant colorectal cancer liver metastases (CRLM).