Innovative Technique · Preliminary single-arm series

Segmental point obliteration technique (SPOT) for nerve-sparing endovenous laser ablation of the below-knee great saphenous vein

Chih-Chun Yang, MDGood Leg Clinic, Taichung, Taiwan

Official title: Segmental point obliteration technique (SPOT) for nerve-sparing endovenous laser ablation of the below-knee great saphenous vein
Author: Chih-Chun Yang, MD
Journal: Journal of Vascular Surgery Cases, Innovations and Techniques
Year & article number: 2026 · 102468
Study type: Innovative Technique · Preliminary single-arm series
Full-text version: Journal Pre-proof (full-text version reviewed)
Published online: 2026-08-25
Submitted / accepted: 2026-07-10 / 2026-08-18
Sample: 13 patients, 19 limbs
Follow-up: 1 month
DOI: 10.1016/j.jvscit.2026.102468
Disclosures & funding: None declared in the paper

Read the DOI article Read the full PDF Technique & patient information

ABSTRACT · EDITORIAL SUMMARY

Abstract: key points

This preliminary series examined intermittent laser delivery for below-knee great saphenous vein ablation, where proximity to the saphenous nerve requires careful risk assessment. The protocol used 6 W for one second per point, approximately 1 mm withdrawal, ultrasound reconfirmation and approximately 1–2 seconds between pulses. At one month, duplex ultrasound showed complete occlusion in all 19 limbs of 13 patients, without reported symptoms in the saphenous nerve distribution. These findings describe feasibility; larger controlled studies and longer follow-up are needed to establish nerve-sparing efficacy and clinical utility.

Patients

Single operator · Single arm

Treated limbs

CEAP C3–C6

19/19

Complete occlusion at 1 month

Confirmed by duplex ultrasound
95% CI: 82.4%–100%

0/19

Reported paresthesia at 1 month

Saphenous nerve distribution
95% CI: 0%–17.6%

Understand the limitations.

A small, single-arm, single-operator series with one month of follow-up, no control group and no blinded assessment. The 95% confidence interval for the event rate extends to 17.6%. These data cannot establish superiority over continuous pullback or other techniques, or guarantee freedom from nerve injury, durable closure or no recurrence.

Paresthesia was elicited by directly questioning patients. Asymptomatic limbs underwent no routine sensory testing, and nerve conduction studies were not performed. Subclinical changes cannot be excluded. There was no tissue thermometry or systematic timing of pauses; the minimum protective interval and proposed thermal mechanism remain unconfirmed.

Ten patients also underwent phlebectomy, and tumescence was used. A single-arm study cannot isolate the effects of SPOT, tumescence or adjunctive procedures.

Source: Yang CC. JVS–CIT. 2026;102468. Abstract, Results, Limitations Original article

STUDY DATA

Original study data

Table I · Patient, vein and procedural characteristics (13 patients, 19 limbs)
Variable	Value
Age, mean ± SD (range)	58 ± 20 years (31–87)
Female, patients (%)	7 (53.8%)
Bilateral treatment, patients (%)	6 (46.2%)
CEAP C3 / C4 / C6, limbs	8 / 7 / 4
Above-knee GSV diameter, mean ± SD	5.3 ± 0.9 mm
Below-knee GSV diameter, mean ± SD	3.1 ± 0.5 mm
Below-knee GSV skin depth, mean ± SD	4.3 ± 1.3 mm
Total treated GSV length, mean ± SD (range)	59.5 ± 10.2 cm (30–75)
SPOT segment length, mean ± SD	21.2 ± 3.2 cm
400 μm / 600 μm fiber, limbs	6 / 13
Above-knee power	6–7 W
Below-knee SPOT power	6 W
Below-knee SPOT LEED	48–60 J/cm
Concomitant phlebectomy, patients (%)	10 (76.9%)

Table II · Outcomes and adverse events (19 limbs)
Outcome	Value
Paresthesia at 1 week	0/19 (0%)
Paresthesia at 1 month	0/19 (0%); 95% CI: 0%–17.6%
Complete occlusion at 1 month	19/19 (100%); 95% CI: 82.4%–100%
Deep vein thrombosis	0 (0%)
Endovenous heat-induced thrombosis	0 (0%)
Skin burn	0 (0%)
Wound infection	0 (0%)

Transcribed from original Tables I and II. SD: standard deviation; GSV: great saphenous vein; LEED: linear endovenous energy density; CI: Clopper–Pearson exact confidence interval. Patient and limb denominators are labeled separately.

Source: Yang CC. JVS–CIT. 2026;102468. Tables I–II Original article

CITATION

Cite this article

Yang CC. Segmental point obliteration technique (SPOT) for nerve-sparing endovenous laser ablation of the below-knee great saphenous vein. J Vasc Surg Cases Innov Tech. 2026;102468. doi:10.1016/j.jvscit.2026.102468.

The UFLA online date is confirmed by PubMed; the SPOT date is from the journal-page image retained in the source project. The SPOT full text is a Journal Pre-proof; no volume or issue is inferred. Refer to the DOI for subsequent bibliographic updates.

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