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Middle-Term Results of 980 nm and 1470 nm Laser and Endovenosus Laser Ablation Theraphy in Lower Extremity Surface Venous Insufficiency Treatment

Yıl 2024, Cilt: 19 Sayı: 1, 49 - 55, 28.03.2024
https://doi.org/10.17517/ksutfd.1183421

Öz

Objective: Superficial venous insufficiency of the lower extremities is a common disease that causes clinical symptoms and can extend to venous ulcers if left untreated. Surgery has been the primary treatment method for many years in the treatment of superficial venous insufficiency and varicose veins. Endovenous laser ablation (EVLA) is a safe and effective minimally invasive treatment method that has recently come to the fore in the treatment of saphenous vein insufficiency. In this study, we aimed to compare the effectiveness, complications, and early and mid-term results of EVLA treatments with different wavelength lasers.
Material and Methods: A hundred symptomatic superficial venous insufficiency patients who applied to Kahramanmaraş Sütçü İmam University Faculty of Medicine Cardiovascular Surgery outpatient clinic and had treatment indication and planned EVLA were included in the study. The patients were divided into two groups. 25 patients had bilateral disease, and a total of 125 lower extremities were treated. A 10W laser with a wavelength of 980 nm was applied to one group (Group 1), and a 10W laser with a wave length of 1470 nm (Group 2) was applied to the other group.
Results: In the 6th-month follow-up, complete occlusion continued in all of the 1470 nm laser-applied group, while recanalization was observed in 3 extremities (5%) of the 980 nm laser-applied patients. Venous clinical severity score (VCSS) and VAS scores were similar in both groups before the procedure. After the procedure, both VCSS (p=0,002) and VAS scores(p<0,001) were significantly lower in Group 2. Likewise, the time to return to daily activities (p<0,001) and the time to feel pain (p<0,001) were shorter in Group 2. While major complications were not seen in both groups, ecchymosis, paresthesia, induration, and analgesia requirement, which are considered minor complications, were less in Group 2 (p<0,0001, p<0,0001, p<0,0001, p<0,001 respectively).
Conclusion: In this study, it was determined that the high laser wavelength used in EVLA treatment was more effective and less postoperative side effects compared to lasers with low laser wavelengths.

Kaynakça

  • Eroğlu E, Yasım A. A Randomised Clinical Trial Comparing N-Butyl Cyanoacrylate, Radiofrequency Ablation and Endovenous Laser Ablation for the Treatment of Superficial Venous Incompetence: Two Year Follow up Results. European Journal of Vascular and Endovascular Surgery 2018;56(4):553-560. Doi: https://doi.org/10.1016/j.ejvs.2018.05.028
  • Durai R, Srodon PD, Kyriakides C. Endovenous laser ablation for superficial venous insufficiency. Int J Clin Pract. 2010 Jan;64(1):61-6. doi: 10.1111/j.1742-1241.2008.01741.x.
  • van den Bremer J, Joosten PP, Hamming JF, Moll FL. Implementation of endovenous laser ablation for varicose veins in a large community hospital: the first 400 procedures. Eur J Vasc Endovasc Surg. 2009 Apr;37(4):486-91. doi: 10.1016/j.ejvs.2008.11.029.
  • Campbell WB, Decaluwe H, Macintyre JB, Thompson JF, Cowan AR. Most patients with varicose veins have fears or concerns about the future, in addition to their presenting symptoms. Eur J Vasc Endovasc Surg. 2006 Mar;31(3):332-4. doi: 10.1016/j.ejvs.2005.08.009.
  • Min RJ, Khilnani N, Zimmet SE. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 2003 Aug;14(8):991-6. doi: 10.1097/01.rvi.0000082864.05622.e4.
  • Yılmaz S. Alt Ekstremite Venöz Sistem Anatomisi ve Ultrasonografi İncelemesi. 27. Ulusal Radyoloji Kongresi Kurs Kitabı 2006; syf: 94-100.
  • Scott TE, LaMorte WW, Gorin DR, Menzoian JO. Risk factors for chronic venous insufficiency: a dual case-control study. J Vasc Surg. 1995 Nov;22(5):622-8. doi: 10.1016/s0741-5214(95)70050-1.
  • Teruya TH, Ballard JL. New approaches for the treatment of varicose veins. Surg Clin North Am. 2004 Oct;84(5):1397-417, viii-ix. doi: 10.1016/j.suc.2004.04.008.
  • Almeida JI, Raines JK. Radiofrequency ablation and laser ablation in the treatment of varicose veins. Ann Vasc Surg. 2006 Jul;20(4):547-52. doi: 10.1007/s10016-006-9098-8.
  • Desmyttère J, Grard C, Wassmer B, Mordon S. Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg. 2007 Dec;46(6):1242-7. doi: 10.1016/j.jvs.2007.08.028.
  • Mundy L, Merlin TL, Fitridge RA, Hiller JE. Systematic review of endovenous laser treatment for varicose veins. Br J Surg. 2005 Oct;92(10):1189-94. doi: 10.1002/bjs.5142.
  • Proebstle TM, Lehr HA, Kargl A, Espinola-Klein C, Rother W, Bethge S, Knop J. Endovenous treatment of the greater saphenous vein with a 940-nm diode laser: thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles. J Vasc Surg. 2002 Apr;35(4):729-36. doi: 10.1067/mva.2002.121132.
  • Kabnick LS. Outcome of different endovenous laser wavelengths for great saphenous vein ablation. J Vasc Surg. 2006 Jan;43(1):88-93. doi: 10.1016/j.jvs.2005.09.033.
  • Kalra M, Gloviczki P. Fifteen years ago laser was supposed to open arteries, now it is supposed to close veins: what is the reality behind the tool? Perspect Vasc Surg Endovasc Ther. 2006 Mar;18(1):3-8. doi: 10.1177/153100350601800102.
  • Proebstle TM, Sandhofer M, Kargl A, Gül D, Rother W, Knop J, Lehr HA. Thermal damage of the inner vein wall during endovenous laser treatment: key role of energy absorption by intravascular blood. Dermatol Surg. 2002 Jul;28(7):596-600. doi: 10.1046/j.1524-4725.2002.01309.x.
  • Min RJ, Zimmet SE, Isaacs MN, Forrestal MD. Endovenous laser treatment of the incompetent greater saphenous vein. J Vasc Interv Radiol. 2001 Oct;12(10):1167-71. doi: 10.1016/s1051-0443(07)61674-1.
  • Goldman MP, Mauricio M, Rao J. Intravascular 1320-nm laser closure of the great saphenous vein: a 6- to 12-month follow-up study. Dermatol Surg. 2004 Nov;30(11):1380-5. doi: 10.1111/j.1524-4725.2004.30431.x.
  • Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999 Mar;53(3):149-53. doi: 10.1136/jech.53.3.149.
  • Weiss RA, Weiss MA. Resolution of pain associated with varicose and telangiectatic leg veins after compression sclerotherapy. J Dermatol Surg Oncol. 1990 Apr;16(4):333-6. doi: 10.1111/j.1524-4725.1990.tb00044.x.
  • Wilder CS. Prevalence of chronic circulatory conditions, United States, 1972. Vital Health Stat 10. 1974 Sep;Series 10(94):1-55.
  • Brasic N, Lopresti D, McSwain H. Endovenous laser ablation and sclerotherapy for treatment of varicose veins. Semin Cutan Med Surg. 2008 Dec;27(4):264-75. doi: 10.1016/j.sder.2008.08.001.
  • Meissner MH, Gloviczki P, Bergan J, Kistner RL, Morrison N, Pannier F, Pappas PJ, Rabe E, Raju S, Villavicencio JL. Primary chronic venous disorders. J Vasc Surg. 2007 Dec;46 Suppl S:54S-67S. doi: 10.1016/j.jvs.2007.08.038.
  • Nael R, Rathbun S. Treatment of varicose veins. Curr Treat Options Cardiovasc Med. 2009 Apr;11(2):91-103. doi: 10.1007/s11936-009-0010-z.
  • van Rij AM, Jiang P, Solomon C, Christie RA, Hill GB. Recurrence after varicose vein surgery: a prospective long-term clinical study with duplex ultrasound scanning and air plethysmography. J Vasc Surg. 2003 Nov;38(5):935-43. doi: 10.1016/s0741-5214(03)00601-3.
  • Jones L, Braithwaite BD, Selwyn D, Cooke S, Earnshaw JJ. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein. Eur J Vasc Endovasc Surg. 1996 Nov;12(4):442-5. doi: 10.1016/s1078-5884(96)80011-6.
  • Rasmussen LH, Bjoern L, Lawaetz M, Blemings A, Lawaetz B, Eklof B. Randomized trial comparing endovenous laser ablation of the great saphenous vein with high ligation and stripping in patients with varicose veins: short-term results. J Vasc Surg. 2007 Aug;46(2):308-15. doi: 10.1016/j.jvs.2007.03.053.
  • Kalteis M, Berger I, Messie-Werndl S, Pistrich R, Schimetta W, Pölz W, Hieller F. High ligation combined with stripping and endovenous laser ablation of the great saphenous vein: early results of a randomized controlled study. J Vasc Surg. 2008 Apr;47(4):822-9; discussion 829. doi: 10.1016/j.jvs.2007.10.060.
  • Lin Y, Ye CS, Huang XL, Ye JL, Yin HH, Wang SM. [A random, comparative study on endovenous laser therapy and saphenous veins stripping for the treatment of great saphenous vein incompetence]. Zhonghua Yi Xue Za Zhi. 2007 Nov 20;87(43):3043-6. Chinese. PMID: 18261348.
  • de Medeiros CA, Luccas GC. Comparison of endovenous treatment with an 810 nm laser versus conventional stripping of the great saphenous vein in patients with primary varicose veins. Dermatol Surg. 2005 Dec;31(12):1685-94; discussion 1694. doi: 10.2310/6350.2005.31309.
  • Timperman PE, Sichlau M, Ryu RK. Greater energy delivery improves treatment success of endovenous laser treatment of incompetent saphenous veins. J Vasc Interv Radiol. 2004 Oct;15(10):1061-3. doi: 10.1097/01.RVI.0000130382.62141.AE.
  • Ravi R, Rodriguez-Lopez JA, Trayler EA, Barrett DA, Ramaiah V, Diethrich EB. Endovenous ablation of incompetent saphenous veins: a large single-center experience. J Endovasc Ther. 2006 Apr;13(2):244-8. doi: 10.1583/05-1760R.1.
  • Maurins U, Rabe E, Pannier F. Does laser power influence the results of endovenous laser ablation (EVLA) of incompetent saphenous veins with the 1 470-nm diode laser? A prospective randomized study comparing 15 and 25 W. Int Angiol. 2009 Feb;28(1):32-7.
  • Sharif MA, Soong CV, Lau LL, Corvan R, Lee B, Hannon RJ. Endovenous laser treatment for long saphenous vein incompetence. Br J Surg. 2006 Jul;93(7):831-5. doi: 10.1002/bjs.5351.
  • Proebstle TM, Moehler T, Herdemann S. Reduced recanalization rates of the great saphenous vein after endovenous laser treatment with increased energy dosing: definition of a threshold for the endovenous fluence equivalent. J Vasc Surg. 2006 Oct;44(4):834-9. doi: 10.1016/j.jvs.2006.05.052.
  • Van den Bos RR, Kockaert MA, Neumann HA, Nijsten T. Technical review of endovenous laser therapy for varicose veins. Eur J Vasc Endovasc Surg. 2008 Jan;35(1):88-95. doi: 10.1016/j.ejvs.2007.08.005.

Alt Ekstremite Yüzeyel Venöz Yetmezlik Tedavisinde 980 nm ve 1470 nm Lazer ile Endovenöz Lazer Ablasyon Tedavisinin Orta Dönem Sonuçları

Yıl 2024, Cilt: 19 Sayı: 1, 49 - 55, 28.03.2024
https://doi.org/10.17517/ksutfd.1183421

Öz

Amaç: Alt ekstremite yüzeyel venöz yetmezlik klinik semptomlara neden olan tedavi edilmediğinde venöz ülserlere kadar uzanabilen ve toplumda sık görülen bir hastalıktır. Yüzeyel venöz yetmezlik ve varislerin tedavisinde uzun yıllardır primer tedavi yöntemi cerrahi tedavidir. Endovenöz lazer ablasyon (EVLA) safen ven yetmezliği tedavisinde, son dönemde ön plana çıkan güvenli ve efektif minimal invaziv tedavi yöntemidir. Bu çalışmamızda, farklı dalga boylu lazerler ile EVLA tedavilerinin etkinliğini, komplikasyonlarını, erken ve orta dönem sonuçlarını karşılaştırmayı amaçladık.
Gereçler ve Yöntemler: Çalışmaya Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Kliniği’ne başvuran, semptomatik yüzeyel venöz yetersizlik tanısı alan ve tedavi endikasyonu konup EVLA planlanan 100 kişi dahil edildi. Hastalar 2 gruba ayrıldı. 25 hastanın bilateral hastalığı mevcuttu, toplam 125 alt ekstremiteye tedavi uygulandı. Bir gruba 980 nm dalga boylu 10W gücünde lazer (Grup 1), diğer gruba ise 1470 nm dalga boylu 10W gücünde lazer (Grup 2) uygulandı.
Bulgular: 6.ay kontrolünde 1470 nm dalga boylu lazer uygulanan grubun tamamında tam oklüzyon devam ederken, 980 nm dalga boylu lazer uygulanan hastaların 3 ekstremitesinde (%5) rekanalizasyon izlendi. Venöz klinik şiddet skoru (VCSS) ve VAS skorları işlem öncesi her 2 grupta da benzerdi. İşlem sonrası Grup 2'de hem VCSS (p=0,002) hem de VAS skoru (p<0,001) anlamlı düşük saptandı. Aynı şekilde günlük aktiviteye dönme süresi (p<0,001) ve ağrı duyma süresi (p<0,001) Grup 2’de daha kısaydı. Her 2 grupta da majör komplikasyon görülmezken, minör komplikasyon olarak kabul edilen ekimoz, parestezi, endürasyon ve analjezi ihtiyacı Grup 2’de daha az (sırasıyla p<0,0001, p<0,0001, p<0,0001, p<0,001) görülmüştür.
Sonuç: Bu çalışmamızda EVLA tedavisinde kullanılan yüksek lazer dalga boyunun düşük lazer dalga boyuna sahip lazerlere kıyasla daha etkin ve daha az postoperatif yan etkilere yol açtığı saptanmıştır.

Kaynakça

  • Eroğlu E, Yasım A. A Randomised Clinical Trial Comparing N-Butyl Cyanoacrylate, Radiofrequency Ablation and Endovenous Laser Ablation for the Treatment of Superficial Venous Incompetence: Two Year Follow up Results. European Journal of Vascular and Endovascular Surgery 2018;56(4):553-560. Doi: https://doi.org/10.1016/j.ejvs.2018.05.028
  • Durai R, Srodon PD, Kyriakides C. Endovenous laser ablation for superficial venous insufficiency. Int J Clin Pract. 2010 Jan;64(1):61-6. doi: 10.1111/j.1742-1241.2008.01741.x.
  • van den Bremer J, Joosten PP, Hamming JF, Moll FL. Implementation of endovenous laser ablation for varicose veins in a large community hospital: the first 400 procedures. Eur J Vasc Endovasc Surg. 2009 Apr;37(4):486-91. doi: 10.1016/j.ejvs.2008.11.029.
  • Campbell WB, Decaluwe H, Macintyre JB, Thompson JF, Cowan AR. Most patients with varicose veins have fears or concerns about the future, in addition to their presenting symptoms. Eur J Vasc Endovasc Surg. 2006 Mar;31(3):332-4. doi: 10.1016/j.ejvs.2005.08.009.
  • Min RJ, Khilnani N, Zimmet SE. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 2003 Aug;14(8):991-6. doi: 10.1097/01.rvi.0000082864.05622.e4.
  • Yılmaz S. Alt Ekstremite Venöz Sistem Anatomisi ve Ultrasonografi İncelemesi. 27. Ulusal Radyoloji Kongresi Kurs Kitabı 2006; syf: 94-100.
  • Scott TE, LaMorte WW, Gorin DR, Menzoian JO. Risk factors for chronic venous insufficiency: a dual case-control study. J Vasc Surg. 1995 Nov;22(5):622-8. doi: 10.1016/s0741-5214(95)70050-1.
  • Teruya TH, Ballard JL. New approaches for the treatment of varicose veins. Surg Clin North Am. 2004 Oct;84(5):1397-417, viii-ix. doi: 10.1016/j.suc.2004.04.008.
  • Almeida JI, Raines JK. Radiofrequency ablation and laser ablation in the treatment of varicose veins. Ann Vasc Surg. 2006 Jul;20(4):547-52. doi: 10.1007/s10016-006-9098-8.
  • Desmyttère J, Grard C, Wassmer B, Mordon S. Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg. 2007 Dec;46(6):1242-7. doi: 10.1016/j.jvs.2007.08.028.
  • Mundy L, Merlin TL, Fitridge RA, Hiller JE. Systematic review of endovenous laser treatment for varicose veins. Br J Surg. 2005 Oct;92(10):1189-94. doi: 10.1002/bjs.5142.
  • Proebstle TM, Lehr HA, Kargl A, Espinola-Klein C, Rother W, Bethge S, Knop J. Endovenous treatment of the greater saphenous vein with a 940-nm diode laser: thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles. J Vasc Surg. 2002 Apr;35(4):729-36. doi: 10.1067/mva.2002.121132.
  • Kabnick LS. Outcome of different endovenous laser wavelengths for great saphenous vein ablation. J Vasc Surg. 2006 Jan;43(1):88-93. doi: 10.1016/j.jvs.2005.09.033.
  • Kalra M, Gloviczki P. Fifteen years ago laser was supposed to open arteries, now it is supposed to close veins: what is the reality behind the tool? Perspect Vasc Surg Endovasc Ther. 2006 Mar;18(1):3-8. doi: 10.1177/153100350601800102.
  • Proebstle TM, Sandhofer M, Kargl A, Gül D, Rother W, Knop J, Lehr HA. Thermal damage of the inner vein wall during endovenous laser treatment: key role of energy absorption by intravascular blood. Dermatol Surg. 2002 Jul;28(7):596-600. doi: 10.1046/j.1524-4725.2002.01309.x.
  • Min RJ, Zimmet SE, Isaacs MN, Forrestal MD. Endovenous laser treatment of the incompetent greater saphenous vein. J Vasc Interv Radiol. 2001 Oct;12(10):1167-71. doi: 10.1016/s1051-0443(07)61674-1.
  • Goldman MP, Mauricio M, Rao J. Intravascular 1320-nm laser closure of the great saphenous vein: a 6- to 12-month follow-up study. Dermatol Surg. 2004 Nov;30(11):1380-5. doi: 10.1111/j.1524-4725.2004.30431.x.
  • Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999 Mar;53(3):149-53. doi: 10.1136/jech.53.3.149.
  • Weiss RA, Weiss MA. Resolution of pain associated with varicose and telangiectatic leg veins after compression sclerotherapy. J Dermatol Surg Oncol. 1990 Apr;16(4):333-6. doi: 10.1111/j.1524-4725.1990.tb00044.x.
  • Wilder CS. Prevalence of chronic circulatory conditions, United States, 1972. Vital Health Stat 10. 1974 Sep;Series 10(94):1-55.
  • Brasic N, Lopresti D, McSwain H. Endovenous laser ablation and sclerotherapy for treatment of varicose veins. Semin Cutan Med Surg. 2008 Dec;27(4):264-75. doi: 10.1016/j.sder.2008.08.001.
  • Meissner MH, Gloviczki P, Bergan J, Kistner RL, Morrison N, Pannier F, Pappas PJ, Rabe E, Raju S, Villavicencio JL. Primary chronic venous disorders. J Vasc Surg. 2007 Dec;46 Suppl S:54S-67S. doi: 10.1016/j.jvs.2007.08.038.
  • Nael R, Rathbun S. Treatment of varicose veins. Curr Treat Options Cardiovasc Med. 2009 Apr;11(2):91-103. doi: 10.1007/s11936-009-0010-z.
  • van Rij AM, Jiang P, Solomon C, Christie RA, Hill GB. Recurrence after varicose vein surgery: a prospective long-term clinical study with duplex ultrasound scanning and air plethysmography. J Vasc Surg. 2003 Nov;38(5):935-43. doi: 10.1016/s0741-5214(03)00601-3.
  • Jones L, Braithwaite BD, Selwyn D, Cooke S, Earnshaw JJ. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein. Eur J Vasc Endovasc Surg. 1996 Nov;12(4):442-5. doi: 10.1016/s1078-5884(96)80011-6.
  • Rasmussen LH, Bjoern L, Lawaetz M, Blemings A, Lawaetz B, Eklof B. Randomized trial comparing endovenous laser ablation of the great saphenous vein with high ligation and stripping in patients with varicose veins: short-term results. J Vasc Surg. 2007 Aug;46(2):308-15. doi: 10.1016/j.jvs.2007.03.053.
  • Kalteis M, Berger I, Messie-Werndl S, Pistrich R, Schimetta W, Pölz W, Hieller F. High ligation combined with stripping and endovenous laser ablation of the great saphenous vein: early results of a randomized controlled study. J Vasc Surg. 2008 Apr;47(4):822-9; discussion 829. doi: 10.1016/j.jvs.2007.10.060.
  • Lin Y, Ye CS, Huang XL, Ye JL, Yin HH, Wang SM. [A random, comparative study on endovenous laser therapy and saphenous veins stripping for the treatment of great saphenous vein incompetence]. Zhonghua Yi Xue Za Zhi. 2007 Nov 20;87(43):3043-6. Chinese. PMID: 18261348.
  • de Medeiros CA, Luccas GC. Comparison of endovenous treatment with an 810 nm laser versus conventional stripping of the great saphenous vein in patients with primary varicose veins. Dermatol Surg. 2005 Dec;31(12):1685-94; discussion 1694. doi: 10.2310/6350.2005.31309.
  • Timperman PE, Sichlau M, Ryu RK. Greater energy delivery improves treatment success of endovenous laser treatment of incompetent saphenous veins. J Vasc Interv Radiol. 2004 Oct;15(10):1061-3. doi: 10.1097/01.RVI.0000130382.62141.AE.
  • Ravi R, Rodriguez-Lopez JA, Trayler EA, Barrett DA, Ramaiah V, Diethrich EB. Endovenous ablation of incompetent saphenous veins: a large single-center experience. J Endovasc Ther. 2006 Apr;13(2):244-8. doi: 10.1583/05-1760R.1.
  • Maurins U, Rabe E, Pannier F. Does laser power influence the results of endovenous laser ablation (EVLA) of incompetent saphenous veins with the 1 470-nm diode laser? A prospective randomized study comparing 15 and 25 W. Int Angiol. 2009 Feb;28(1):32-7.
  • Sharif MA, Soong CV, Lau LL, Corvan R, Lee B, Hannon RJ. Endovenous laser treatment for long saphenous vein incompetence. Br J Surg. 2006 Jul;93(7):831-5. doi: 10.1002/bjs.5351.
  • Proebstle TM, Moehler T, Herdemann S. Reduced recanalization rates of the great saphenous vein after endovenous laser treatment with increased energy dosing: definition of a threshold for the endovenous fluence equivalent. J Vasc Surg. 2006 Oct;44(4):834-9. doi: 10.1016/j.jvs.2006.05.052.
  • Van den Bos RR, Kockaert MA, Neumann HA, Nijsten T. Technical review of endovenous laser therapy for varicose veins. Eur J Vasc Endovasc Surg. 2008 Jan;35(1):88-95. doi: 10.1016/j.ejvs.2007.08.005.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Murat Arı 0000-0001-7998-0416

Ahmet Büyük 0000-0002-5427-4563

Orhan Bozoğlan 0000-0001-5646-3600

Erdinç Eroğlu 0000-0003-1146-6677

Erken Görünüm Tarihi 28 Mart 2024
Yayımlanma Tarihi 28 Mart 2024
Gönderilme Tarihi 4 Ekim 2022
Kabul Tarihi 20 Ekim 2022
Yayımlandığı Sayı Yıl 2024 Cilt: 19 Sayı: 1

Kaynak Göster

AMA Arı M, Büyük A, Bozoğlan O, Eroğlu E. Alt Ekstremite Yüzeyel Venöz Yetmezlik Tedavisinde 980 nm ve 1470 nm Lazer ile Endovenöz Lazer Ablasyon Tedavisinin Orta Dönem Sonuçları. KSÜ Tıp Fak Der. Mart 2024;19(1):49-55. doi:10.17517/ksutfd.1183421