Ke wehe nei i ka Superior Occlusion, ka ʻeha postoperative liʻiliʻi, a me ka hoʻōla wikiwiki ʻana o ka maʻi ma ka Phlebology Hou
Hoʻopilikia ka maʻi venous insufficiency (CVI) a me nā veins varicose o nā lālā haʻahaʻa i nā haneli miliona o ka poʻe ma ka honua holoʻokoʻa, e hoʻoulu ana i ke kaumaha o ka wāwae mau, ka edema, ka ʻeha, ka dermatitis stasis, a me nā ʻeha venous e hoʻi hou ana. ʻOiai ʻo ka wehe ʻoki maʻamau (high ligation and stripping) i lawelawe mua ʻia ma ke ʻano he lāʻau lapaʻau mua, ua neʻe koʻikoʻi ke ʻoki vascular hou i ka minimally invasive endovenous thermal ablation. I kēia lā,Lapaʻau Laser Endovenous (EVLT / EVLA)ke kūlana gula i ʻōlelo ʻia e ka ʻaelike phlebology honua—e hāʻawi ana i nā helu occlusion kiʻekiʻe loa, nā hopena hoʻonaninani kupaianaha, a ʻaneʻane ʻaʻohe noho haukapila.
No ka hoʻoponopono ʻana i nā palena mau o nā lasers monochromatic mua—e like me ka ecchymosis postoperative, ka ʻeha i hoʻoulu ʻia e ka wela, a me nā pilikia recanalization—hoʻolauna ʻo TRIANGEL i kāna hae nui.ʻŌnaehana Laser Diode ʻoki kino V6 Dual-Wavelength (980nm + 1470nm),i hana ʻia me ka hui pū ʻana me ka 360° Radial Optical Fiber Technology ponoʻī no ka occlusion endovascular kīnā ʻole.
1. Pili ʻana o Dual-Chromophore: ʻO ke Kiʻekiʻe Biophysical o 980nm + 1470nm
ʻO ke kūleʻa lapaʻau koʻikoʻi o EVLT e kau ana ma luna o ka occlusion photothermal i kuhikuhi ʻia: ka hoʻoili ʻana i ka ikehu optical i loko o ka ikehu thermal e hoʻololi i ka matrix collagen o ka paia vein (intima a me media), e hoʻoulu ai i ka ʻūlū mau o ke kīʻaha koko a me ka fibrous obliteration ma hope. Hoʻohana ka paepae TRIANGEL V6 i ʻelua mau nalu hoʻopihapiha kiʻekiʻe e hoʻomaikaʻi i ka omo ʻana o ka wai a me ka hemoglobin:
*1470 nm — Ka Omo Wai Koho no ka ʻAna Mālie a Pāpaʻu:ʻO ka wai ka chromophore nui i loko o ka lining endothelial a me ka paia vein. Hōʻike ka nalu 1470nm i kahi coefficient absorption i loko o ka wai ma kahi o 40 mau manawa kiʻekiʻe ma mua o 980nm, a ʻoi aku ka nui ma mua o 810nm a i ʻole 1064nm. ʻAe kēia i ka ikehu wela e kaupalena ʻia i kahi ʻāpana ablation pāpaʻu loa i kāohi pono ʻia i loko o ka paia vein. No laila, ua hoʻemi ʻia ka hoʻokumu ʻana o ka pehu mahu, ua pale ʻia ka huhū o ke aʻalolo perivascular, a ua hoʻemi nui ʻia ka ecchymosis postoperative (bruising).
*980 nm — Ka Hoʻopili ʻana o ka Hemoglobin Kiʻekiʻe no ka Coagulation Wikiwiki a me ka Hemostasis:ʻOiai ʻo 1470nm e hoʻoponopono hou i ke collagen kūkulu o ka paia o ke kīʻaha koko, kūlike ʻo 980nm me ka spectrum absorption kiʻekiʻe o ka oxyhemoglobin a me ka deoxyhemoglobin. Hāʻawi kēia i ka photocoagulation intravascular koke, e hoʻopaʻa ana i nā kahawai venous collateral a pale i ka extravasation intraoperative a me ke kahe ʻana o ke koko.
★ HOʻOMANAʻO KUMUKŪʻAI LAʻAU: IKAIKA HAʻAHAʻA, ʻOLUʻOLU KIʻEKIʻE
ʻO ka ʻaelike lapaʻau: ʻO ka hui pū ʻana o 980nm a me 1470nm e hiki ai i nā kauka lapaʻau ke hana ma ka fluence holoʻokoʻa haʻahaʻa loa (Joules/cm) i hoʻohālikelike ʻia me nā ʻāpana nalu hoʻokahi 980nm, e hoʻokō ana i ka 100% occlusion vein koke like me ka hoʻemi ʻana i nā helu ʻeha maʻi (VAS) ma mua o 65%.
2. 360° Radial Optical Fiber: Hoʻokuʻu ʻana o ke anapuni like
ʻO kahi holomua nui i ka EVLT hou ka hoʻololi ʻana mai nā olonā ʻōlohelohe maʻamau i nā olonā Radial Optical cylindrical kūikawā. Hoʻokuʻu nā olonā ʻōlohelohe i ka ikehu laser i mua ma ke axis o ke kīʻaha koko, kahi e hoʻoulu pinepine ai i ka hoʻomehana kūloko ʻole, nā piko wela kiʻekiʻe, a me kahi pilikia i ʻike ʻia o ka perforation o ka paia vein. I ka hoʻohālikelike ʻana, hoʻolauna ka TRIANGEL Radial Optical Fiber i kahi micro-prism silica refractive ponoʻī ma ka piko distal:
*Hoʻouna ʻoiaʻiʻo 360° Circumferential:Hoʻolaha like ʻia ka ikehu i loko o kahi cylinder piha 360-degere e kū pono ana i ka paia o ka moku, e hōʻoiaʻiʻo ana i ka emi ʻana o ka collagen a puni ke anapuni aʻa holoʻokoʻa i ka wā e huki ʻia ai ke kaula i hope.
*Hoʻopau ʻana i ka Perforation a me Carbonization:Ma ka pale ʻana i ka hoʻopili pololei ʻana ma waena o ka piko o ke olonā wela loa a me ke intima o ke aʻa, pale ka hoʻokuʻu radial i ka puhi ʻana o ka paia o ke aʻa focal a me ka hyperpigmentation o ka ʻili.
*Hōʻoia Hoʻopili Optical (<20% Pohō Ikehu):He nui nā olonā maʻamau ma ka mākeke e ʻeha ana i nā pohō hoʻoili pili optical ma mua o 20%, e hopena ana i ka lawe ʻana i ka ikehu sub-therapeutic a me ka recanalization vein lōʻihi. Hoʻohiki ka ʻōnaehana TRIANGEL LASEEV i ka pili SMA905 pololei, e hōʻoiaʻiʻo ana i ka 100% o ka ikehu nominal i calibrated ʻia e hoʻoili piha ʻia i loko o ke kahua lapaʻau.
3. Kaʻina Hana Lapaʻau Ma waho i Hoʻohālikelike ʻia: Mālama Hele Waena, Hele Waena i Waho
Ua hana ʻia ke kaʻina hana TRIANGEL V6 EVLT no ka hoʻokō maʻalahi ʻana ma lalo o ka anesthesia tumescent kūloko. ʻO ke kaʻina hana ablation vein saphenous maʻamau e pono ai he 25 a 40 mau minuke wale nō a hahai i kahi kaʻina hana lapaʻau ʻelima pae paʻa:
• KaʻAnuʻu Hana 1: Puncture i alakaʻi ʻia e ka Ultrasound:Ma lalo o ke alakaʻi ʻana a Duplex ultrasound, hoʻokumu ʻia ke komo percutaneous ma ka medial malleolus a i ʻole ma lalo o ke kuli me ka hoʻohana ʻana i kahi nila puncture 18G.
• KaʻAnuʻu Hana 2: Ke Kau ʻana o ka Uea Alakaʻi Hydrophilic:Hoʻoneʻe mālie ʻia kahi uea alakaʻi hydrophilic 0.035-'īniha ma o ka lumen catheter i loko o ka aʻa saphenous nui (GSV).
• KaʻAnuʻu Hana 3: Ke Ana ʻana i ka Mamao i SFJ:Ua hoʻoponopono pololei ʻia ka lōʻihi mai ke kiko puncture a i ka projection o ka saphenofemoral junction (fossa ovalis) ma lalo o ka ultrasound.
• KaʻAnuʻu Hana 4: Ke Kau ʻana o ka Catheter Multi-Purpose a me ke Fiber Radial:Aia ka ʻeke hoʻohānau ma kahi o 1.5–2.0 cm ka mamao mai ka hui ʻana o ke aʻa epigastric, a ua hoʻouka ʻia ke olonā radial 360°.
• KaʻAnuʻu 5: Tumescent Anesthesia & Laser Ablation:Hoʻokomo ʻia ka hopena tumescent anu ma ke ʻano perivascular e hana i kahi cushion wai pale a hiolo i ka paia o ke aʻa ma luna o ke olonā. Hoʻāla ʻia ka laser diode V6 ma ke ʻano nalu hoʻomau (CW) i ka wā e huki ʻia ai ke olonā i hope ma 1-2 mm/sec (target Linear Endovenous Energy Density: 50–70 J/cm).
Hoʻokele Ma hope o ke Kaʻina Hana: Hoʻopili koke ʻia nā kāʻei hoʻopaʻa a i ʻole nā kāmaʻa hoʻopaʻa lapaʻau papa-II ma ka wāwae i mālama ʻia. Paipai ʻia nā mea maʻi e hele koke no 20 mau minuke a hiki ke hoʻi koke i ka home. Mālama ʻia ka hoʻopaʻa ʻana no 7 a 14 mau lā. Hōʻoia ka ultrasound Duplex ma hope o ka fibrosis segmental, ka echo haʻahaʻa, ka non-compressibility, a me ka ʻole o ka reflux.
Ka manawa hoʻouna: ʻOkakopa-28-2026