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endovenous laser ablation of great saphenous vein with ultrasound-guided perivenous tumescence： early and midterm results

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Chinese Medical Journal 2013年第3期126卷 421-425页

作者： CHEN Jia-quan XIE Hui DENG Hao-yu YUAN Kai ZHANG Ji-wei ZHANG Hao ZHANG Lan Department of Vascular Surgery Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai 200127 China

Background endovenous laser ablation （EVLA） is an improved method to treat varicose great saphenous veins （GSV） with a high satisfactory rate. This study aimed to evaluate the efficiency and safety of treatment by EVLA procedures with ultrasound-guided perivenous tumescence. Methods Thirty-one patients （31 limbs） with symptomatic varicose vein primary to chronic venous insufficiency （CVI） treated with EVLA were prospectively studied. The entire procedure was performed under ultrasound-guided tumescent local anesthesia. The patients were evaluated with a 18 month follow-up postoperation using clinical examination and venous duplex ultrasonography. Pain scores and quality of life （QOL） were recorded using visual analog scale （VAS） and the chronic venous insufficiency questionnaire （CIVIQ） at 1 week, 1 month, and 12 months after operation. Results All patients tolerated EVLA procedure well. The overall success occlusion rates of GSV were 92%, 94%, and 94% at 1, 12, and 18 months follow-up, respectively. The score of CIVIQ one week preoperation was 69.14±11.44 while that of CIVIQ one month postoperation was 85.32±4.89. The life quality has significantly improved after the operation of EVLA （t=12.71, P 〈0.05）. The VAS one month after treatment was lower than 1 week before therapy （t=8.048, P 〈0.05）. Major complications such as deep vein thrombosis and skin burns were not found. Most of the complications were minor and improved quickly. Conclusions This refinement type of EVLA procedure is a safe and effective treatment with a high satisfaction rate; it displayed noteworthy features including shortening hospitalization, early ambulant activity, and preferable occlusion rates.

关键词： endovenous laser ablation great saphenous vein occlusion tumescent anaesthesia

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Higher Energy Does Not Mean Better Outcome Following endovenous laser ablation of Great Saphenous Vein

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World Journal of Cardiovascular Surgery 2014年第11期4卷 200-205页

作者： Celalettin Karatepe Mustafa Aldemir Bayer Cinar Akif Onalan Halim Issever Onur S.Goksel Cardiovascular Surgery Department Medical FacultyMustafa Kemal UniversityAntakyaTurkey Cardiovascular Surgery Department School of MedicineAfyon Kocatepe UniversityAfyonkarahisarTurkey Cardiovascular Surgery Department Medical Park HospitalIstanbulTurkey Cardiovascular Surgery Department Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey Biostatistics and Public Health Department Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey

Background: endovenous laser ablation is a relatively newer alternative to treat great saphenous vein insufficiency. We evaluated the efficiency and safety of treatment endovenous laser procedures on the different saphenous vein diameters with different energy levels. Methods: Data regarding endovenous laser ablation of symptomatic chronic great saphenous venous insufficiency in 209 patients were prospectively recorded. Patients were grouped into two main groups based on their diameters as 5 to 7 millimeters (Group A) or more than 7 millimeters (Group B). Patients in each group was randomized into two groups as >90 J/cm (A1 and B1) or 80-90 J/cm (A2 and B2). Postoperative outcome and complications were recorded during follow-ups at 1st week;1st, 3rd and 6th months to examine the venous reflux and recanalization. Results: Perioperative complaints as pain, cramps and ankle swelling were more commonly observed in A1 group. Fatigue was more common in A2 and B2 groups. No major complications as deep vein thrombosis or skin burns were observed. Conclusions: endovenous laser ablation is a safe and effective procedure with a high satisfaction rate shortening hospitalization durations and early ambulant activity. Pain, ankle swelling and fatigue are the most common minor complaints in the early postoperative period.

关键词： endovenous laser ablation Great Saphenous Vein Varices

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Strategies and challenges in treatment of varicose veins and venous insufficiency

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World Journal of Clinical Cases 2022年第18期10卷 5946-5956页

作者： Rong-Ding Gao Song-Yi Qian Hai-Hong Wang Yong-Sheng Liu Shi-Yan Ren Department of laser and Vascular Surgery Aviation General HospitalChina Medical UniversityBeijing 100012China Department of Cardiac Surgery Zhongshan Hospital(Xiamen Brach)Fudan UniversityXiamen 361015Fujian ProvinceChina Department of Peripheral Vascular Disease The Affiliated Hospital of Shanxi University of Chinese MedicineTaiyuan 030024Shanxi ProvinceChina Department of Dermatology Aviation General HospitalChina Medical UniversityBeijing 100012China

Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences.In the recent decade,the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular techniques.The literature was systematically searched on Medline without language restrictions.All papers on the treatment of varicose veins and venous insufficiency with different procedures were included and reviewed.endovenous laser ablation(EVLA)and radiofrequency ablation(RFA)both are same safe and effective in terms of occlusion rate,and time to return to normal activity.In comparison with RFA or EVLT,Cure conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire(CHIVA)may cause more bruising and make little or no difference to rates of limb infection,superficial vein thrombosis,nerve injury,or hematoma.In terms of recurrence of varicose veins,there is little or no difference between CHIVA and stripping,RFA,or EVLT.Great saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy(FS)group(51%)during 1 year of follow-up.The 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy.Although the mechanochemical endovenous ablation(MOCA)is a non-thermal,non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage,the overall success rate of MOCA is lower than those of other procedures such as EVLA,RFA,or high ligation and stripping.EVLA is the most cost-effective therapeutic option,with RFA being a close second for the treatment of patients with varicose veins.endovenous thermal ablation(EVLA or RFA)is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose veins.Ultrasound-guided FS is associated with a high recurrence

关键词： Varicose veins Venous insufficiency High ligation and stripping endovenous laser ablation Radiofrequency ablation Cure conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire

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