Successful single-center experiences of laser crossectomy in zone zero in Endovenous Laser Ablation (EVLA) for chronic venous insufficiency - a case series.

Zone-zero laser crossectomy achieved complete obliteration of treated great saphenous veins with no recanalization observed during the 3-month follow-up period.

• Duplex ultrasound confirmed complete obliteration of all treated GSVs
• Follow-up was conducted at 7 days, 4, 8, and 12 weeks with physical and duplex ultrasound examinations
• 57 consecutive patients were included in the case series
• No recanalization was observed at any follow-up time point through 3 months

The overall postoperative complication rate was low, with all complications being mild and managed conservatively.

• Leg pain occurred in 3 cases (5.26%)
• EHIT (Endovenous Heat-Induced Thrombus) grade I-II occurred in 1 case (1.75%)
• Hyperpigmentation occurred in 1 case (1.75%)
• Paresthesia occurred in 1 case (1.75%)
• All complications were described as mild and managed conservatively

The study population consisted of 57 consecutive patients with symptomatic GSV insufficiency spanning CEAP clinical classes C2 through C6.

• Mean patient age was 61.6 years
• All patients had symptomatic GSV insufficiency classified as CEAP C2-C6
• All patients underwent EVLA using a 1470 nm radial double-ring swift laser
• Zone-zero ablation was performed exactly at the 0 cm zone of the saphenofemoral junction (SFJ)

Zone-zero laser crossectomy is defined as laser ablation performed exactly at the 0 cm zone of the saphenofemoral junction, as a modification of conventional EVLA.

• Conventional EVLA is typically performed 1-2 cm distal to the saphenofemoral junction (SFJ)
• Conventional technique was noted to often leave residual tributaries, increasing the risk of recurrence
• Zone-zero ablation was proposed as a minimally invasive alternative to eliminate residual stumps and reduce varicose vein recurrence
• The technique used a 1470 nm radial double-ring swift laser

Chronic venous insufficiency is described as a prevalent and underdiagnosed disease with a substantial global burden.

• CVI affects over 25 million adults worldwide
• EVLA is described as the gold standard for great saphenous vein insufficiency
• GSV insufficiency treated with conventional EVLA carries risk of recurrence due to residual tributaries at the SFJ stump