By: Lowell S. Kabnick, MD Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.

1. 2 Things New! 1920nm Laser & New
Saphenous Vein Closure Device
Lowell S. Kabnick, MD
NYU Langone Medical Center

2. A Novel Secure Percutaneous
Vessel Occluder
for Venous Reflux Disease

3. Vessel Occluder
Deployment Occlusion

4. Occluder in Action

5. Transection of OccludedCarotid Artery

6. Physician
‣ Can reduce procedural time
‣ Allows treatment of multiple areas of incompetence
in a single session
‣ No capital expense
‣ USG skill known
‣ Minimal post-intervention care
‣ Can be coupled with other procedures-ex. chemical
‣ CHIVA
Potentials

7. Patient
‣ Local anesthesia (not tumescent)
‣ Minimal discomfort
‣ No recovery period
‣ No compression therapy needed
Potentials

8. ▶ Small Saphenous Vein Reflux
▶ Refluxing Junctional Tributaries
▶ Perforator Reflux
▶ Reflux in Large Tributaries
▶ Recurrent Reflux after Ablation
Therapies
▶ Veins too tortuous to ablate
▶ Prevention of Chemical Creep
▶ Ligation in conjunction with
chemical therapies, sclerosants,
glues
▶ CHIVA AVMs
Indications

9. 1920nm Diode Laser
(Drawing)

10. Group 1 1470nm laser
• n = 46 (limbs)
• 32 pts, 24 female, 8
male
• 46 limbs
• 41 GSV
• 5 SSV
medium follow-up: 242.7 days ±
146.4
•Medium age: 54.3 ± 14.7
•LEED medium: 24.6 ± 5.3 J/cm
Group 2 1920nm laser
• n = 55 (limbs)
• 38 pts, 28 female, 10
male
• 55 limbs
• 48 GSV
• 7 SSV
medium follow-up: 163.1 days ±
50.0
• Medium age: 52.2 ± 12.9
• LEED medium: 17.3 ± 4.5 J/cm

11. 1470nm
Power:
• 7 to 10W GSV
•3 to 6 W SSV
1920nm
Power:
• 5 to 6 W GSV
• 3 to 5 W SSV

12. Operative variables 1470nm 1920nm
Operative time (min) 32.9 ± 12.1 25.0 ± 7.9
Mean total energy (J) 174.30 ±
389.0
823.4 ± 353.3
LEED (J/cm) 24.6 ± 5.3 17.3 ± 4.5
LEED - GSV (J/cm) 24.6 ± 5.4 17.9 ± 4.5
LEED - SSV (J/cm) 24.2 ± 3.9 13.7 ± 2.5

13. Post-operative variables
Bruising (Ecchymosis) 21 (45.7%) 12 (21.8%)
Induration 18 (39.1%) 7 (12.7%)
Paresthesia 5 (10.9%) 3 (5.5%)
Skin burn 0 0
Deep venous thrombosis 0 0
Days to return to normal
activities
2.7 ± 2.4 4.3 ± 2.5
Days of use of
analgesics
2.0 ± 2.5 2.0 ± 2.3
Days with pain 2.8 ± 2.7 1.7 ± 2.0

14. pre-op 7 day 1 month 3 months
CEAP
1470nm
1920nm
3.4 ± 0.9
3.3 ± 0.6
3.1 ± 1.3
2.3 ± 1.3
2.4 ± 1.5
2.2 ± 1.4
2.3 ± 1.6
2.2 ± 1.4
VCSS
1470nm
1920nm
7.7 ± 2.7
7.7± 2.7
2.2 ± 1.7
2.4 ± 1.4
1.5 ± 1.4
1.5 ± 1.1
1.2 ± 0.9
1.4 ± 1.0

15. Closure Rates
Group 1
Laser 1470 nm
(n = 46)
Group 2
Laser 1908 nm
(n = 55)
1 week 97.3% ± 12.5 95.9% ± 13.3
1 month 97.1% ± 12.7 91.8% ± 17.3
3 months 95.1% ± 17.3 91.2% ± 19.1

17. Division of Vascular and Endovascular Surgery