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Endovascular laser ablation

Gokhan Kuyumcu, Gloria Maria Salazar, Anand M Prabhakar, Suvranu Ganguli
Incompetent superficial veins are the most common cause of lower extremity superficial venous reflux and varicose veins; however, incompetent or insufficient perforator veins are the most common cause of recurrent varicose veins after treatment, often unrecognized. Perforator vein insufficiency can result in pain, skin changes, and skin ulcers, and often merit intervention. Minimally invasive treatments have replaced traditional surgical treatments for incompetent perforator veins. Current minimally invasive treatment options include ultrasound guided sclerotherapy (USGS) and endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources...
December 2016: Cardiovascular Diagnosis and Therapy
Luca Spinedi, Heiko Uthoff, Sasan Partovi, Daniel Staub
Varicose veins of the lower extremity (VVLE) are a frequently encountered vascular disorder in the general population. The general view that VVLE are a non-serious disease with primarily aesthetic impact is a common misconception, as the disease can have a significant negative impact on generic and disease-specific quality of life. Further, VVLE may be associated with potentially threatening clinical conditions, such as chronic venous ulceration, venous thromboembolism and haemorrhage from ruptured varicose veins...
2016: Swiss Medical Weekly
Marco Apperti, Ermenegildo Furino, Antonio Sellitti, Gennaro Quarto
AIM: To explain the mode of using and the obtained results during EVLA procedures and sclerotherapies with support of Visioven®, a laser transillumination instrument. MATERIALS AND METHODS: 205 patients suffering from Chronic Venous Insufficiency - CEAP-C stage 1-2 enrolled (103 females and 102 males) and divided into two groups. A Group: patients candidate for sclerotherapy; B Group: patients to be subjected to endovascular laser ablation (EVLA). In both groups patients were divided into two sub-groups on the basis of the use of Visioven® or not during the procedure...
2016: Annali Italiani di Chirurgia
Sulaiman S Shoab, Danielle Lowry, Alok Tiwari
OBJECTIVE: The aim of this preliminary study was to document the effect of treated great saphenous vein (GSV) length on short-term outcomes using freedom from secondary intervention as a marker. METHODS: Analysis was performed of a prospective database of endovascular laser therapy (EVLT) procedures performed by a single surgeon in an NHS hospital setting using a standardized technique in a series of consecutive ambulatory patients. During a 2-year period, 131 episodes with sufficient data were recorded...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Jung Hak Kwak, Sang Il Min, Song-Yi Kim, Ahram Han, Chanjoong Choi, Sanghyun Ahn, Jongwon Ha, Seung-Kee Min
Although endovenous heat-induced thrombosis (EHIT) is frequently reported after endovenous laser ablation (EVLA), the incidence and timing of occurrence of EHIT are not fully understood. We present a case of EHIT successfully treated with a combination of surgical and endovascular treatments. A 57-year-old woman, two months post bilateral EVLA, presented with a swollen leg. Deep vein thrombosis was diagnosed by Doppler ultrasonography and computerized tomographic venography. We treated the patient with catheter-directed thrombolysis with urokinase after insertion of an inferior vena cava filter...
June 2016: Vascular Specialist International
O Yu Usenko, M O Artemenko, G M Uninets
No abstract text is available yet for this article.
January 2016: Klinichna Khirurhiia
R R Osmanov
Abstract The results of endovascular laser ablation (EVLA) under ultrasonographic control in treatment of the lower extremities varicose disease (LEVD) in 189 patients (214 extremities) were analyzed. There was established, that for the trustworthy information obtaining the ultrasonographic duplex angioscanning conduction is necessary. The fibrous involution of a big subcutaneous vein trunk was achieved in (97.7 ± 1.0)% observations, in (1.9 ± 0.9)%--while the clinical signs absence--there were revealed the echo-signs of a reflux recurrence--the "ultrasonographic recurrence", and in one observation--a clinical recurrence of LEVD...
February 2016: Klinichna Khirurhiia
Gennaro Quarto, Bruno Amato, Umberto Giani, Giacomo Benassai, Emanuele Gallinoro, Marco Apperti, Ermenegildo Furino
AIM: This paper aims to compare EVLA to traditional surgery, by evaluating the incidence of recurrences. MATERIAL OF STUDY: We performed a meta-analysis to challenge both surgical and LASER treatment, using, as clinical outcome, the presence or the absence of reflux. A systematic review of literature about the treatment of varicose veins was performed, searching in the following databases: PUBMED-MEDLINE, Cochrane Library. Search terms considered were: stripping, HL/S, surgery, LASER, EVL*, varicose vein, GSV, saphenous vein...
2016: Annali Italiani di Chirurgia
Masafumi Izumi, Yuichi Ikeda, Hiroharu Yamashita, Yoshinari Asaoka, Mitsuhiro Fujishiro, Masahiro Shin, Yoshihisa Abo
Endovenous laser ablation (EVLA), which is a relatively new therapeutic option for saphenous varicose veins of the legs, is less invasive than conventional stripping surgery with ligation. In this study, we evaluated the safety and effectiveness of EVLA combined with ligation for severe saphenous varicose veins that were graded as ≥ C4 by the CEAP classification. We treated 119 Japanese patients (141 limbs) between July 2005 and December 2007 utilizing a 1320-nm Nd:YAG laser. The obliteration rate of the treated veins was found to be 100% over the entire follow-up period (2...
2016: International Heart Journal
W S J Malskat, J Giang, M G R De Maeseneer, T E C Nijsten, R R van den Bos
BACKGROUND: The independent effect of wavelength used for endovenous laser ablation (EVLA) on patient-reported outcomes, health-related quality of life (HRQoL), treatment success and complications has not yet been established in a randomized clinical trial. The aim was to compare two different wavelengths, with identical energy level and laser fibres, in patients undergoing EVLA. METHODS: Patients with great saphenous vein incompetence were randomized to receive 940- or 1470-nm EVLA...
February 2016: British Journal of Surgery
K Rass, N Frings, P Glowacki, S Gräber, W Tilgen, T Vogt
OBJECTIVE: To compare the long-term clinical efficacy of endovenous laser ablation (EVLA) with high ligation and stripping (HLS) as standard treatment for great saphenous vein (GSV) incompetence. DESIGN: Investigator initiated two centre randomized controlled trial with 5 year follow up. MATERIALS AND METHODS: Interventions were performed on ambulatory and hospitalized patients at two vein centres, a university dermatology department (EVLA) and a specialized vein clinic (HLS)...
November 2015: European Journal of Vascular and Endovascular Surgery
Neil M Khilnani
No abstract text is available yet for this article.
September 2015: Journal of Vascular and Interventional Radiology: JVIR
Tomohiro Ogawa
Endovenous ablation of saphenous veins using laser energy was approved by the Japanese Ministry of Health, Labor and Welfare in 2011 as a more effective, less-invasive method than classical treatment for varicose veins. New medical laser and radiofrequency devices for this purpose were also approved in 2014. A requirement for the treatment of varicose veins with health insurance reimbursement using these devices is a physician with sufficient knowledge of endovenous ablation. The management standards for endovenous ablation set by varicose vein specialist medical societies are used to accredit qualified physicians who have basic clinical experience in the treatment of varicose veins, qualified instructors, and safe, effective medical facilities...
May 2015: Nihon Geka Gakkai Zasshi
Ronald S Winokur, Neil M Khilnani, Robert J Min
INTRODUCTION: The patterns of recurrent varicose veins after endovascular ablation of the saphenous veins are not well described. METHODS: The current study describes the ultrasound defined recurrence patterns seen in 58 patients (79 limbs) who returned for evaluation of recurrent varicose veins from a cohort of 802 patients treated with endovenous laser ablation and subsequent sclerotherapy from March 2000 to March 2007 with clinical follow-up until May 2014. FINDINGS: The most common ultrasound defined recurrence patterns leading to the varicose veins were new reflux in the anterior accessory saphenous and small saphenous veins as well as recanalization of the treated saphenous segment...
August 2016: Phlebology
S K van der Velden, A A M Biemans, M G R De Maeseneer, M A Kockaert, P W Cuypers, L M Hollestein, H A M Neumann, T Nijsten, R R van den Bos
BACKGROUND: A variety of techniques exist for the treatment of patients with great saphenous vein (GSV) varicosities. Few data exist on the long-term outcomes of these interventions. METHODS: Patients undergoing conventional surgery, endovenous laser ablation (EVLA) and ultrasound-guided foam sclerotherapy (UGFS) for GSV varicose veins were followed up for 5 years. Primary outcome was obliteration or absence of the treated GSV segment; secondary outcomes were absence of GSV reflux, and change in Chronic Venous Insufficiency quality-of-life Questionnaire (CIVIQ) and EuroQol - 5D (EQ-5D™) scores...
September 2015: British Journal of Surgery
Mehmet Mahir Atasoy
PURPOSE: To investigate the efficacy and safety of endovenous laser ablation (EVLA) with high energy delivery in large great saphenous veins (GSVs) at 1-year sonographic follow-up. MATERIALS AND METHODS: Retrospective review of 385 patients who underwent EVLA between August 2011 and September 2013 was conducted, and 44 consecutive patients (21 women [47%]; mean age, 41 y; range, 23-66 y) with 49 large GSVs were included. Vein size and clinical follow-up results were recorded...
September 2015: Journal of Vascular and Interventional Radiology: JVIR
Manfred Kalteis, Peter Adelsgruber, Susanne Messie-Werndl, Odo Gangl, Irmgard Berger
PURPOSE: To report 5-year follow-up data of a randomized study comparing high ligation and stripping (HL + S) with high ligation and endovenous laser ablation (HL + EVLA) of the great saphenous vein (GSV). METHODS: One hundred patients were randomized. After 5 years, patient satisfaction with the overall result, CEAP-C class, VCSS, CIVIQ2 quality of life score, and recurrence rate were assessed (clinical examination and duplex ultrasound). RESULTS: Five-year follow-up rates were 83% HL + S and 68% HL + EVLA...
May 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Monzer Chehab, Purushottam Dixit, Elias Antypas, Mare Juncaj, Oliver Wong, Michael Bischoff
PURPOSE: To describe technical feasibility and safety of perforating vein ablation with the use of a 1,470-nm laser and bare-tip fiber in the management of chronic venous insufficiency (CVI). MATERIALS AND METHODS: A total of 171 perforating veins were ablated in 101 limbs of 87 patients (mean age, 54.4 y; 79% female). Outcomes included sonographic occlusion of ablated perforator, subjective changes of insufficiency symptoms, incidence of procedure-related side effects (pain, hyperpigmentation), and complications (burn, infection, deep vein thrombosis, paresthesia)...
June 2015: Journal of Vascular and Interventional Radiology: JVIR
J El-Sheikha, D Carradice, S Nandhra, C Leung, G E Smith, B Campbell, I C Chetter
BACKGROUND: Consensus regarding compression following treatment of varicose veins has yet to be reached. This systematic review aims to establish the optimal compression regimen after venous treatment. METHODS: A systematic review of MEDLINE, Embase and CENTRAL was performed to identify randomized clinical trials (RCTs) investigating different compression strategies following treatment for superficial venous insufficiency. RESULTS: Seven RCTs comparing different durations and methods of compression fulfilled the inclusion criteria...
June 2015: British Journal of Surgery
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