Patients experienced significantly less pain when the 1470 nm laser was used.
Dr. Thomas Wright of the Laser Lipo and Vein Center in St Louis performed a comparative study finding significant variation in pain and discomfort levels when vein procedures were performed using two different laser fibers, one 1470 nanometer and one 810 nanometer. The results of this study were recently published in the prestigious medical journal Phlebology.
The study was performed on fifty-two (52) patients with incompetent greater saphenous veins. Twenty-six (26) of the patients were treated by 1470 nm radial emitting and twenty-six (26) by 810 nm diode emitting fibers set to 15W. The average diameter of segments treated was 7.54 mm for 1470 nm and 6.56 mm for 810 nm. All laser ablations were performed with perivenous tumescent anesthesia using lidocaine diluted in saline to a concentration of .05%.
The average length of segment treated was 39.88 cm for 1470 nm and 35 cm for 810 nm. The average linear energy density for all segments treated by 1470 nm radial emitting laser was 51.8 J/cm compared to 81.1 J/cm for 810 nm diode emitting fiber.
The results were significant. The amount of pain experienced during the procedure was rated on a scale of 0-10, ten being most severe. The average maximum pain rating for 1470 nm fiber was 0.31 compared to 1.0 for 810 nm fiber. This was a statistically significant difference at the 95% confidence interval, with a p-value of .0500.
Using the same pain scale, Dr. Wright assessed one week post-operative pain. The average maximum pain rating for the 1470 nm was 0.69, and 2.08 for the 810 nm. With a p-value of .0027, the results were statistically significant at 95% confidence interval.
After one week, discomfort was reported by 12 of 26 (46%) treated with the 1470 nm fiber and by 17 of 26 (65.4%) treated with the 810 nm fiber. The calculated odds ratio indicated patients to be 2.22 times more likely to experience discomfort from the 810 nm laser versus the 1470 nm laser.
After both one week and one month, closure rates for 1470 nm fiber were 26 out of 26 or 100%. The closure rate for 810 nm fiber were 24 out of 26 (92.3%) at one week and 25 out of 26 (96.1%) at one month. After one week, discomfort was reported by 12 of 26 (46%) in 1470 nm fiber and by 17 of 26 (65.4%) in 810 nm fiber.
The comparative study demonstrates a significant difference in pain ratings, both during and one week after the procedure. When treated with the 1470 nm radial emitting fiber, patients’ reported pain levels that were significantly lower than patients treated with an 810 nm laser. The risk of patient discomfort was found to be 45% greater with the 810 nm laser.
Endovenous laser treatment has become a popular procedure for superficial vein treatment since the approval of laser ablation by the FDA in 2002. Two of the most popular lasers in use today for treatment of veins are the 1470 nm and 810 nm lasers. An important concern of patients that led to this comparative study is the pain and discomfort experienced, which this study found is a direct result of the difference in energy levels of the lasers.
Dr. Thomas Wright is the Medical Director of the Laser Lipo and Vein Center in St Louis, Missouri. His practice specializes in vein treatment and cosmetic medicine, including liposuction, cosmetic surgery, body sculpting and treatment and diagnosis of vein disease.
Dr. Wright was one of the first two-hundred-plus surgeons in the United States to become board certified in Phlebology by the American Board of Phlebology. Dr. Wright received his undergraduate degree from Duke University in Durham, NC and completed his medical training at the University of Missouri at Columbia. He completed his residency at the University of Alabama Birmingham. He is also a registered medical sonographer, credentialed by the American Registry for Diagnostic Medical Sonography, a Fellow of the American Society of Laser Medicine and Surgery, and a former Howard Hughes Research Fellow.
To contact Dr. Thomas Wright of the Laser Lipo and Vein Center in St Louis, Missouri call (636) 614-1665 or visit http://www.stlouislaserveins.com.
