Innovative Technique · Single case report

The sheathless ultrafine laser ablation technique for managing deep muscle branch reflux in hostile anatomy following rhabdomyosarcoma resection

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

Official title: The sheathless ultrafine laser ablation technique for managing deep muscle branch reflux in hostile anatomy following rhabdomyosarcoma resection
Author: Chih-Chun Yang, MD
Journal: Journal of Vascular Surgery Cases, Innovations and Techniques
Year & article number: 2026 · 102274
Study type: Innovative Technique · Single case report
Full-text version: Version of record · August 2026, volume 12, issue 4
Published online: 2026-04-29
Submitted / accepted: 2026-02-06 / 2026-04-16
Sample: 1 patient
Follow-up: 3 months
DOI: 10.1016/j.jvscit.2026.102274
Disclosures & funding: None declared in the paper

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

ABSTRACT · EDITORIAL SUMMARY

Abstract: key points

A 45-year-old woman developed heaviness, swelling and a popliteal venous aneurysm 26 years after rhabdomyosarcoma resection and radiotherapy. Duplex assessment identified a 1.5 cm refluxing deep muscle branch that could not accommodate a standard introducer sheath. A 400 μm radial fiber was introduced through an 18G peripheral IV catheter; treatment used 7 W, one-second pulses and 2 mm withdrawal increments. Superficial laser treatment and phlebectomy were also performed. At three months the branch was occluded and the aneurysm thrombosed without residual flow. This single case describes short-term technical feasibility, without establishing population success rates or comparative safety.

Patient

45-year-old woman · CEAP C3

3 months

Follow-up

Clinical and duplex assessment

60 min

Total procedure time

Includes superficial procedures

1–2

Pain VAS score

Observation in this case

Source: Yang CC. JVS–CIT. 2026;102274. Abstract, Results, Limitations Original article

STUDY DATA

Original study data

Original article figures

Original UFLA Fig. 1. A and B: pretreatment left popliteal venous aneurysm and lateral calf varicosities. C and D: posterior and lateral photographs of the same patient three months after treatment. — **Fig. 1 · Clinical presentation and three-month outcome**
A and B show the pretreatment appearance; C and D show the three-month follow-up. The report describes resolution of the popliteal bulge and lateral varicosities. Superficial laser treatment and ambulatory phlebectomy were performed in the same session, so the appearance cannot be attributed to deep muscle branch UFLA alone. This is one patient’s outcome.
View full-size figure

Original UFLA Fig. 2. A: the deep muscle branch labeled PERFORATOR connects to a partially thrombosed aneurysm. B: the fiber enters through an 18G catheter. C and D: branch occlusion and aneurysm thrombosis at three months. — **Fig. 2 · Duplex ultrasound and procedural technique**
A: the refluxing branch connects to the venous aneurysm; THROMBUS denotes clot. B: a 400 μm radial fiber passes directly through an 18G catheter without an introducer sheath. C: the branch appears as a hyperechoic fibrotic cord at three months. D: the aneurysm is thrombosed, with no detectable flow. Original image labels are preserved.
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Original UFLA Fig. 3: a WONTECH BA400 R radial optical fiber beside a standard 18G peripheral intravenous catheter for physical comparison. — **Fig. 3 · The 400 μm fiber and 18G catheter**
The BA400 R radial fiber is shown beside a standard 18G peripheral intravenous catheter. The paper reports direct passage through the catheter lumen, eliminating the introducer sheath. This is an equipment photograph, not a manufacturer’s dimensioned engineering drawing.
View full-size figure

Source: Yang CC. JVS–CIT. 2026;102274. Figs. 1–3 Original article

CITATION

Cite this article

Yang CC. The sheathless ultrafine laser ablation technique for managing deep muscle branch reflux in hostile anatomy following rhabdomyosarcoma resection. J Vasc Surg Cases Innov Tech. 2026;12(4):102274. doi:10.1016/j.jvscit.2026.102274.

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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