Iranian Journal of Medical Physics

Iranian Journal of Medical Physics

Effect of Pullback Speed and the Distance between the Skin and Vein on the Performance of Endovenous Laser Treatment by Numerical Simulation

Document Type : Original Paper

Authors
Alireza Rezvani-sharif 1
Malikeh Nabaei 2
1 Cardiovascular Engineering Lab, Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
2 Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
10.22038/ijmp.2018.27108.1278
Abstract
Introduction: Endovenous laser treatment (ELT) is a new treatment method for the reflux of the great saphenous vein. A successful ELT is dependent on the selection of optimum parameters required to achieve optimal vein damage while avoiding side effects including skin burns. The mathematical modeling of ELT can be used to understand the process of ELT. This study was conducted to examine the effect of laser pullback speed and the distance between the vein and skin on the performance of ELT.
Material and Methods: The finite element method was used to develop optical-thermal damage models and simulate the process of ELT process. Firstly, light distribution was modeled using the diffusion approximation of the transport theory. On the second step, temperature rise was determined by solving the bioheat equation. Considering the temperature field, the extension of laser-induced tissue damage was estimated using Arrhenius model.
Results: Regarding the results, pullback speed and the distance between the vein and the skin distance can affect the process of ELT. Moreover, the pullback speed of 1 mm/s, 2 mm/s, and 4mm/s were suitable for the treatment of varicose veins located in a depth of 15 mm, 10 mm, and 5 mm, respectively.
Conclusion: In the ELT method, the pullback speed should be determined considering the geometry of the varicose vein segments, especially the distance between the skin and vein.
Keywords
Endovenous laser treatment
Varicose vein
Bioheat transfer
Thermal damage
Numerical simulation
Subjects
  1. Min, R.J., N. Khilnani, and S.E. Zimmet, Endovenous laser treatment of saphenous vein reflux: long-term results. Journal of vascular and interventional radiology, 2003. 14(8): p. 991-996.
  2. Kurz, X., et al., Do varicose veins affect quality of life? Results of an international population-based study. Journal of vascular surgery, 2001. 34(4): p. 641-648.
  3. Smith, J., et al., Evaluating and improving health-related quality of life in patients with varicose veins. Journal of vascular surgery, 1999. 30(4): p. 710-719.
  4. Mundy, L., et al., Systematic review of endovenous laser treatment for varicose veins. British journal of surgery, 2005. 92(10): p. 1189-1194.
  5. Sarin, S., J. Scurr, and P. Smith, Assessment of stripping the long saphenous vein in the treatment of primary varicose veins. British journal of surgery, 1992. 79(9): p. 889-893.
  6. 6.            Weiss, R.A. and M.A. Weiss, Controlled Radiofrequency Endovenous Occlusion Using a Unique Radiofrequency Catheter Under Duplex Guidance to Eliminate Saphenous Varicose Vein Reflux: A 2‐Year Follow‐Up. Dermatologic surgery, 2002. 28(1): p. 38-42.
  7. Puggioni, A., et al., Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. Journal of vascular surgery, 2005. 42(3): p. 488-493.
  8. Mordon, S.R., B. Wassmer, and J. Zemmouri, Mathematical modeling of endovenous laser treatment (ELT). BioMedical Engineering OnLine, 2006. 5(1): p. 26.
  9. Almeida, J., et al., Saphenous laser ablation at 1470 nm targets the vein wall, not blood. Vascular and endovascular surgery, 2009.
  10. Biemans, A.A., et al., Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. Journal of vascular surgery, 2013. 58(3): p. 727-734. e1.
  11. Van den Bos, R.R., et al., Heat conduction from the exceedingly hot fiber tip contributes to the endovenous laser ablation of varicose veins. Lasers in medical science, 2009. 24(2): p. 247-251.
  12. Mordon, S.R., B. Wassmer, and J. Zemmouri, Mathematical modeling of 980‐nm and 1320‐nm endovenous laser treatment. Lasers in surgery and medicine, 2007. 39(3): p. 256-265.
  13. Marqa, M.F., et al., Numerical simulation of endovenous laser treatment of the incompetent great saphenous vein with external air cooling. Lasers in medical science, 2013. 28(3): p. 833-844.
  14. Satokawa, H., et al., Comparison of endovenous laser treatment for varicose veins with high ligation using pulse mode and without high ligation using continuous mode and lower energy. Annals of vascular diseases, 2010. 3(1): p. 46-51.
  15. Vuylsteke, M., et al., Endovenous laser treatment of saphenous vein reflux: how much energy do we need to prevent recanalizations? Vascular and endovascular surgery, 2008.
  16. Agalar, M., et al., Endovenous laser treatment of varicose veins. 2012.
  17. Van Ruijven, P.W., et al., Optical-thermal mathematical model for endovenous laser ablation of varicose veins. Lasers in medical science, 2014. 29(2): p. 431-439.
  18. Rezvani-Sharif, A. and M. Nabaei, Numerical simulation of endovenous laser treatment of saphenous vein varicose. 2nd conference on novel approach of biomedical engineering in cardiovascular disease, Tehran, Iran, 2016: p. 96.
  19. Alfano, R.R., et al. Optical Tomography, Photon Migration, and Spectroscopy of Tissue and Model Media: Theory, Human Studies, and Instrumentation. 1995. SPIE.
  20. Patterson, M.S., B.C. Wilson, and D.R. Wyman, The propagation of optical radiation in tissue I. Models of radiation transport and their application. Lasers in Medical Science, 1991. 6(2): p. 155-168.
  21. Bergman, T.L., F.P. Incropera, and A.S. Lavine, Fundamentals of heat and mass transfer. 2011: John Wiley & Sons.
  22. Marqa, M.F., S. Mordon, and N. Betrouni, Laser interstitial thermotherapy of small breast fibroadenomas: Numerical simulations. Lasers in surgery and medicine, 2012. 44(10): p. 832-839.
  23. Marqa, M.-F., et al., Focal laser ablation of prostate cancer: numerical simulation of temperature and damage distribution. Biomedical engineering online, 2011. 10(1): p. 45.
  24. Chang, I.A. and U.D. Nguyen, Thermal modeling of lesion growth with radiofrequency ablation devices. Biomedical engineering online, 2004. 3(1): p. 1.
  25. HernÁndez Osma, E., et al., A comparative study of the efficacy of endovenous laser treatment of the incompetent great saphenous under general anesthesia with external air cooling with and without tumescent anesthesia. Dermatologic Surgery, 2013. 39(2): p. 255-262.
  26. Disselhoff, B., et al., Endovenous laser ablation: an experimental study on the mechanism of action. Phlebology, 2008. 23(2): p. 69-76.
  27. Vuylsteke, M., et al., Endovenous laser treatment: a morphological study in an animal model. Phlebology, 2009. 24(4): p. 166-175.

 

 

Iranian Journal of Medical Physics
Volume 15, Issue 4 - Serial Number 4
Autumn 2018
Pages 277-284

  • Receive Date 23 October 2017
  • Revise Date 15 February 2018
  • Accept Date 15 February 2018