A Prospective Safety and Effectiveness Study Using Endovenous Laser Ablation with a 400-mm Optical Fiber for the Treatment of Pathologic Perforator Veins in Patients with Advanced Venous Disease

What does that mean for my veins?

In this study, Dr. Kathleen Gibson and her other physician co-investigators evaluated the effectiveness of a new technique to treat abnormal leg veins that can be the cause of venous ulcers using a small laser fiber placed through a tiny needle to close the abnormal veins. This technique has been used for many years now to treat varicose veins of the leg, but those devices are too big to treat the short-segment perforator veins that can cause leg vein ulcers.

Venous ulcers are large “skin sores” that occur on the lower leg and are one of the most severe forms of vein disease. These ulcers generally occur on the inside of the lower leg, just above the ankle, and they are very painful and difficult to heal, often requiring months of specialized treatment at a wound care center.

Some of these ulcers occur due to “leaking valves” in the perforator veins of the legs, which are short vein segments that connect the superficial veins that are just beneath the skin to the deeper veins that are under the muscle layers (picture of the “crossbar” of capital letter “H” to get a better visual of these perforator veins).

The perforator veins are supposed to function so that blood is directed only in one direction – from the outside superficial veins, to the inside deep veins. Small one-way valves within these veins allow the flow to only go in the correct, outside-to-inside direction. When these one-way valves malfunction, blood can flow in the other direction, toward the “outside” superficial veins, which puts an abnormal, high pressure on the surrounding skin thus allowing ulcers to form and not heal properly.

Dr. Gibson and her colleagues studied this new procedure in 83 patients with leg vein ulcers and other forms of severe skin injury due to abnormal flow direction (reflux) in perforator veins. The small laser fiber is only 4/10ths of a millimeter in width, allowing it to be placed into the abnormal perforator vein using only local anesthesia (skin numbing medicine) and ultrasound to guide the needle and laser catheter into the abnormal vein. When the laser is activated it closes the vein, sealing the vein shut. These perforator veins are often less than an inch long, so you can think of this technique like “spot welding” the inside of the vein.

The results were very good. The initial success rate of the procedure was 95%, and over the course of the next 12 months the patients as a group showed significant improvement in ulcer healing, other symptoms such as leg pain, and in overall quality of life.

This is one of several available treatments for severe leg vein problems such as venous leg ulcers, all of which are available at Carolina Vein Care., including this new laser treatment of perforator veins. We work closely with local wound healing centers treating these complex patients. If you or a loved one suffer from leg vein ulcers, please call and see if we can help you.

Mark R. Jackson, M.D.
Board Certified Vascular Surgeon

* Original article “Spontaneous hemorrhage from varicose veins: A single-center experienceA prospective safety and effectiveness study using endovenous laser ablation with a 400-μm optical fiber for the treatment of pathologic perforator veins in patients with advanced venous disease” published in September 2020 by authors Kathleen Gibson, MD; Steven Elias, MD; Mark Adelman, MD; Eric S.Hager, MD; David J.Dexter, MD; Sathish Vayuvegula, MD; Paramjit Chopra, MD; Lowell S. Kabnick, MD.
Original citation: Journal of Vascular Surgery: Venous and Lymphatic Disorders. Volume 8, Issue 5, September 2020, Pages 805-813

Meet Dr. Jackson

Carolina Vein Care | Vein Specialists in Greenville, SC | Varicose Veins, Spider Veins, Reticular Veins | Team Headshots | Mark R. Jackson, MD

Dr. Jackson then moved to Greenville in 2003 where he has practiced vascular surgery, started the vascular surgery program at St. Francis Hospital which in 2015 was recognized as a HealthGrades Top 50 Hospital in Vascular Surgery. Dr. Jackson has now started a new, independent medical practice with Dr. Julie Park specializing in the treatment of venous disorders such as varicose veins of the legs.