If reflux of the great saphenous vein is treated not only above but also below the knee with laser therapies such as ELVeS from biolitec, recurrences are less common
Jena, 10th October 2024 – The medical technology company biolitec offers, with its ELVeS laser therapy, an endovenous laser ablation (EVLA) for minimally invasive treatment of varicose veins. A recent guideline for the treatment of varicose veins in the lower extremities recommends EVLA instead of high ligation and stripping (HLS) for the treatment of reflux in the great saphenous vein. (1) This is pointed out in an article published in June 2024 on the treatment of great saphenous vein insufficiency above and below the knee by Tae Sik Kim, M.D., Ph.D. of Korea University Guro Hospital in Seoul. (2)
Indeed, Sussmann et al. showed that additional treatment below the knee is more beneficial for preventing recurrence when treatment above and below the knee is performed with EVLA rather than HLS. (3) The value of the association measure (odds ratio) of 0.1857 used in the above-mentioned study is clearly below 1 and shows that fewer recurrences occur in the group with under-the-knee treatment than in the group without under-the-knee treatment. The additional EVLA treatment below the knee therefore contributes significantly to the prevention of recurrences. At the same time, the P-value (significance value) of less than 0.0001 confirms the high significance of this correlation. For HLS, the association is significantly weaker, with an odds ratio of 0.62. Accordingly, an HLS treatment below the knee that is carried out in addition to the HLS treatment above the knee hardly contributes to the prevention of recurrences. In contrast, EVLA offers clear advantages in the prevention of recurrences when the treatment is carried out not only above but also below the knee.
In connection with EVLA’s relative safety with regard to possible damage to the saphenous nerve, Kim also refers to a study by Gifford et al. (4) According to this study, the risk of damage to the saphenous nerve when treating GSV reflux below the knee with laser ablation is significantly lower than with classic stripping. Neuralgia after EVLA is only 4%, while after stripping, damage to the saphenous nerve can be observed in 39% of cases.
Endovenous laser ablation of the great saphenous vein can be performed very well with biolitec’s ELVeS therapy. The ELVeS Radial 2ring Swift fiber is suitable for truncal veins, side branches and perforators. The ELVeS Radial 2ring Pro laser fiber also allows sclerotherapy of severely tortuous veins. At the same time, the LEONARDO 1940 offers even more efficient absorption of water components in the vein wall and ensures rapid recovery and excellent aesthetic results. The ELVeS Radial fibers are particularly safe thanks to the FUSION technology, in which the light guide and quartz fiber tip are fused together, withstanding high temperatures and tensile forces. For more information about ELVeS and the other minimally invasive laser therapies, please visit www.biolitec.com
1 Gloviczki P, et al.: The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part I. Duplex scanning and treatment of superficial truncal reflux: endorsed by the Society for Vascular Medicine and the International Union of Phlebology. J Vasc Surg Venous Lymphat Disord 2023;11:231-61.
https://www.jvsvenous.org/action/showPdf?pii=S2213-333X%2822%2900417-6
2 Tae Sik Kim: Extended Management of the Great Saphenous Vein Insufficiency Below the Knee. Ann Phlebology 2024; 22(1): 6-8 https://doi.org/10.37923/phle.2024.22.1.6
3 Matthew S. Sussman et al.: A systematic review of the treatment of residual below the knee venous reflux after endovenous thermal ablation of the great saphenous vein; JVS-VL Journal of Vascular Surgery; Elsevier Inc. 2021; https://doi.org/10.1016/j.jvsv.2021.03.024
4 Gifford S.M. et al.: Reflux in the below-knee great saphenous vein can be safely treated with endovenous ablation. J Vasc Surg Venous Lymphat Disord 2014;2:397-402; https://pubmed.ncbi.nlm.nih.gov/26993545/
Die biolitec® ist eines der weltweit führenden Medizintechnik-Unternehmen im Bereich minimal-invasive Laseranwendungen und bietet im Bereich der Photodynamischen Therapie (PDT) die lasergestützte Behandlung von Krebserkrankungen mit dem in der EU zugelassenen Medikament Foscan® an. Die biolitec® hat sich seit 1999 vor allem auf die Entwicklung von neuen minimal-invasiven, schonenden Laserverfahren konzentriert. Der einzigartige LEONARDO®-Diodenlaser von biolitec® ist der erste universell einsetzbare medizinische Laser, der über eine Kombination von zwei Wellenlängen, 980 nm und 1470 nm, verfügt und fachübergreifend verwendbar ist. ELVeS® Radial® (ELVeS® = Endo Laser Vein System) ist das weltweit am häufigsten eingesetzte Lasersystem zur Behandlung der venösen Insuffizienz. In der Proktologie bietet die biolitec® eine maximal schließmuskelschonende Therapie für Analfisteln als auch Behandlungsformen für Hämorrhoiden und Steißbeinfisteln an. In der Urologie hat sich das Therapieangebot vom Bereich gutartiger Prostatavergrößerung (BPH) auf Blasen- sowie Prostatatumoren erweitert. Speziell für die mobile Anwendung vor Ort wurde der nur 900 g leichte LEONARDO® Mini-Laser entwickelt. Schonende Laseranwendungen in den Bereichen Gynäkologie, HNO, Thorax-Chirurgie und Pneumologie, Ästhetik sowie Orthopädie gehören ebenfalls zum Geschäftsfeld der biolitec®. Weitere Informationen unter www.biolitec.de
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biolitec® Holding GmbH & Co KG
Jörn Gleisner
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Phone: +49 (0) 3641 / 51953-36
Fax: +49 (0) 3641 / 51953-33
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Url: http://www.biolitec.de
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biolitec
Jörn Gleisner
Otto-Schott-Straße 15
07745 Jena
Phone: +49 (0) 3641 / 51953-36
Fax: +49 (0) 3641 / 51953-33
E-Mail: 
Url: http://www.biolitec.de
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