Risk Management in Laser Treatment of Varicose Vein of Lower Extremity with High Ligation of Great Saphenous Vein

Objective: High ligation of great saphenous vein combined with laser in the treatment of varicose veins of lower limbs is a minimally invasive and efficient operation, which is widely used.However, there is less discussion on the risk control and management of this kind of operation.So the study was undertaken to identify the hidden dangers and risks and improve the safety of operation.Methods: 214 cases (201 patients) of lower extremity treated by high ligation of great saphenous vein combined with laser in varicose vein cavity were treated from January 2016 to December 2018.The complications, adverse events and treatment were analyzed.There were no great saphenous vein, root injury of great saphenous vein, guide wire entering deep vein, guide wire or cannula breaking or breaking, skin nerve burn, local skin and soft tissue thermal injury in the groin incision.The patients were followed up for 1 month to 3 years.Results: 30 cases (14.0%) had risk or adverse events.During the operation, there were 7 cases without great saphenous vein in the groin incision, 3 cases with root injury of great saphenous vein, 3 cases with guide wire entering deep vein, 1 case with guide wire breaking, and 1 case with cannula burning through and breaking.In the follow-up, 8 cases had local skin and soft tissue thermal injury, 3 cases had saphenous nerve burn, 2 cases had lower extremity deep vein thrombosis and 2 cases had recurrence operated again.Other patients had no adverse consequences.Conclusion: Open operation and intracavitary interventional treatment are better than single operation, but at the same time, they have double risks.During and after the operation, appropriate measures should be taken according to the causes to avoid serious consequences.