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Venous ablation

Igor A Zolotukhin, Evgeny I Seliverstov, Elena A Zakharova, Alexander I Kirienko
OBJECTIVE: To establish an effect of isolated phlebectomy in patients with incompetent great saphenous vein (Ambulatory Selective Varices Ablation under Local anesthesia (ASVAL) procedure) on the reflux and diameter of the trunk and to assess recurrence rate of varicose veins at one year. MATERIAL AND METHODS: We conducted a prospective study on patients with primary varicose veins and with C2 or C2,3 or C2,3,4 or C2,4 classes of chronic venous disease and great saphenous vein incompetence...
October 19, 2016: Phlebology
Marianne E Witte, Suzanne Holewijn, Ramon R van Eekeren, Jean-Paul de Vries, Clark J Zeebregts, Michel M P J Reijnen
PURPOSE: To report the midterm results of mechanochemical ablation (MOCA) for treating great saphenous vein (GSV) insufficiency. METHODS: In a 1-year period, 85 consecutive patients (median age 51.4 years; 71 women) undergoing MOCA with polidocanol in 104 limbs were enrolled in a prospective registry. The patients were evaluated at baseline and during follow-up (4 weeks and 1, 2, and 3 years) using duplex ultrasound, the CEAP (clinical, etiologic, anatomic and pathophysiologic) classification, the Venous Clinical Severity Score (VCSS), the RAND Short Form 36-Item Health Survey (RAND-SF36), and the Aberdeen Varicose Vein Questionnaire (AVVQ)...
October 14, 2016: Journal of Endovascular Therapy
Atsushi Tabuchi, Hisao Masaki, Yasuhiro Yunoki, Yoshiko Watanabe, Hiroshi Furukawa, Takahiko Yamasawa, Hiroki Takiuchi, Takeshi Honda, Noriaki Kuwada, Kenji Kojima, Kazuo Tanemoto
We performed a comparative study of surgical outcomes and venous functions between endovenous laser ablation with a 980-nm diode laser (EV group) and thigh stripping (ST group). There were no severe complications and initial success rates were 100% in both groups. In the EV group, preoperative symptoms improved in 94.3% of cases, the venous occlusion rate was 98%, and endovenous heat induced thrombosis had occurred in 11.9% (Class 3: 0.7%) at 12 months after the operation. Although comparative study of postoperative venous function by air plethysmography showed significant improvement in both groups, there was less recovery of postoperative venous function in the EV than in the ST group...
2016: Annals of Vascular Diseases
Stefan Nydahl
Modern management of varicose veins Chronic venous disease is a common medical condition and occurs in about one-third of the adult population. Reflux, and to a much lesser extent obstruction of the superficial and deep venous systems, generates venous hypertension. The goal of the treatment is to reduce venous hypertension in order to prevent complications, progression of venous disease and to improve patients' quality of life. Today we have a wide spectrum of different treatment options at our disposal. Management is based upon accurate clinical diagnosis and duplex imaging...
October 4, 2016: Läkartidningen
Aldo Bonso, Mauro Fantinel, Giovanna Scalchi, Sabrina Ferrara, Stefano Indiani, Federico Calore, Claudia Licciardello
AIMS: The effectiveness of atrial fibrillation (AF) ablation relies on detailed knowledge of the anatomy of the left atrium (LA) and pulmonary veins (PVs). It is common to combine computed tomography/magnetic resonance (CT/MR) with imaging by electroanatomical (EA) mapping systems. The aim of this study was to evaluate the accuracy of LA anatomical reconstruction by 'One Model' and 'VeriSense' tools (Ensite Velocity 3.0, St Jude Medical), compared with CT/MR imaging. METHODS AND RESULTS: Seventy-two patients with AF underwent pre-procedural imaging (97% CT-scan, 3% MR imaging) and transcatheter ablation of PVs...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Omar Rodriguez-Acevedo, Kristen E Elstner, Kui Martinic, Aaron Zea, Jenny Diaz, Rodrigo T Martins, Fernando Arduini, Alexandra Hodgkinson, Nabeel Ibrahim
BACKGROUND: Endovenous radio frequency ablation for small saphenous vein incompetence by and large appears to be superior and safer than conventional open surgery. Small saphenous vein ablation from approximately mid-calf to the point proximally where the small saphenous vein dives into the popliteal fossa is considered to be safe, as the sural nerve is in most cases separated from this segment of the small saphenous vein by the deep fascia. The outcome of the distal incompetent small saphenous vein remains unclear...
September 29, 2016: Phlebology
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
Thomas M Runge, Nicholas J Shaheen, Zorka Djukic, Suzanne Hallquist, Roy C Orlando
BACKGROUND: After ablation of Barrett's esophagus (BE), the esophagus heals with neosquamous epithelium (NSE). Despite normal endoscopic appearance, NSE exhibits defective barrier function with similarities to defects noted in the distal esophageal epithelium in patients with gastroesophageal reflux disease (GERD). AIM: To determine whether patients with NSE, unlike patients with healthy esophageal epithelium, have C-terminal fragments (CTFs) of e-cad detectable on tissue biopsy...
November 2016: Digestive Diseases and Sciences
Christoph A Maurer, Mikolaj Walensi, Samuel A Käser, Beat M Künzli, René Lötscher, Anne Zuse
AIM: To evaluate liver resections without Pringle maneuver, i.e., clamping of the portal triad. METHODS: Between 9/2002 and 7/2013, 175 consecutive liver resections (n = 101 major anatomical and n = 74 large atypical > 5 cm) without Pringle maneuver were performed in 127 patients (143 surgeries). Accompanying, 37 wedge resections (specimens < 5 cm) and 43 radiofrequency ablations were performed. Preoperative volumetric calculation of the liver remnant preceeded all anatomical resections...
August 28, 2016: World Journal of Hepatology
A Bauschke, A Altendorf-Hofmann, C Malessa, S Schüle, J Zanow, U Settmacher
AIM: In the 7th edition of the TNM classification, not only HCC with distant metastases but also those with regional lymph node metastases are classified as stage IV. MATERIALS AND METHODS, RESULTS: From our prospectively recorded tumor registry, 138 patients (17 %) with HCC were in stage IV. Among those were 68 and 70, respectively, in stage IVA (regional lymph node metastases) and IVB (distant metastases). The tumors were less frequently treated with resection or local ablative treatment (chemoembolization, RFA, SIRT, percutaneous radiation) than patients in stage I-III...
September 15, 2016: Journal of Cancer Research and Clinical Oncology
Riccardo Cappato, Robert Welsh
The vast clinical research programme for the direct, oral factor Xa inhibitor rivaroxaban has generated a wealth of data since the first rivaroxaban approval in 2008 for the prevention of venous thromboembolism (VTE) in patients undergoing elective hip or knee replacement surgery. While rivaroxaban is widely used across a spectrum of seven indications, there is continuous commitment to investigating its wider benefits in new indications and attempts to refine current evidence. Key data from recently completed randomised controlled trials (RCTs) have shown that rivaroxaban is a feasible anticoagulation option for patients with non-valvular atrial fibrillation (NVAF) undergoing cardioversion or catheter ablation...
September 28, 2016: Thrombosis and Haemostasis
Masato Okada, Akio Hirata, Kazunori Kashiwase, Yasuharu Takeda, Takayoshi Nemoto, Koshi Matsuo, Keisuke Ueno, Yuji Nishimoto, Ryuta Sugihara, Ayaka Murakami, Yasunori Ueda, Yoshio Yasumura
BACKGROUND: Dissociated pulmonary vein activity (DPVA), defined as isolated intrinsic ectopic beats observed after successful pulmonary vein (PV) isolation, indicates the presence of remnant foci of trigger ectopy but has yet to be extensively studied. We investigated the correlation between DPVA and the PV triggers of atrial fibrillation (AF). METHOD AND RESULTS: Consecutive 110 patients undergoing AF ablation were enrolled. We defined trigger ectopy as documented ectopic foci observed to spontaneously initiate AF...
September 7, 2016: Journal of Cardiology
Shekeeb Sufian, Alejandro Arnez, Nicos Labropoulos, Sanjiv Lakhanpal
BACKGROUND: The purpose of this study was to evaluate the risks of bleeding, deep venous thrombosis (DVT), endovenous heat induced thrombosis (EHIT) and failure of ablation on patients who undergo ablation while on oral anticoagulation. METHODS: We compared 378 (3.4%) out of 11252 patients (Group A) who had undergone 724 endovenous ablation of the saphenous veins from January 1, 2011 to September 30, 2014 while on oral anticoagulation to a randomly selected 375 patients (Group B) who underwent 641 endovenous ablation in the same time period but were not on anticoagulation...
September 6, 2016: International Angiology: a Journal of the International Union of Angiology
Fady Dawoud, Karl H Schuleri, David D Spragg, B Milan Horáček, Ronald D Berger, Henry R Halperin, Albert C Lardo
INTRODUCTION: The interplay between electrical activation and mechanical contraction patterns is hypothesized to be central to reduced effectiveness of cardiac resynchronization therapy (CRT). Furthermore, complex scar substrates render CRT less effective. We used novel cardiac computed tomography (CT) and noninvasive electrocardiographic imaging (ECGI) techniques in an ischemic dyssynchronous heart failure (DHF) animal model to evaluate electrical and mechanical coupling of cardiac function, tissue viability, and venous accessibility of target pacing regions...
August 30, 2016: Journal of Cardiovascular Electrophysiology
Paolo Nicola Marino, Anna Degiovanni, Lara Baduena, Eraldo Occhetta, Gabriele Dell'Era, Tamas Erdei, Alan G Fraser
BACKGROUND: As atrial stiffness (Kla) is an important determinant of cardiac pump function, better mechanical characterization of left atrial (LA) cavity would be clinically relevant. Pulmonary venous ablation is an option for atrial fibrillation (AF) treatment that offers a powerful context for improving our understanding of LA mechanical function. We hypothesized that a relation could be detected between invasive estimation of Kla and new non-invasive deformation parameters and traditional LA and left ventricular (LV) function descriptors, so that Kla can be estimated non-invasively...
August 23, 2016: Journal of Cardiology
M Venermo, J Saarinen, E Eskelinen, S Vähäaho, E Saarinen, M Railo, I Uurto, J Salenius, A Albäck
BACKGROUND: Endovenous ablation techniques and ultrasound-guided foam sclerotherapy (UGFS) have largely replaced open surgery for treatment of great saphenous varicose veins. This was a randomized trial to compare the effect of surgery, endovenous laser ablation (EVLA) (with phlebectomies) and UGFS on quality of life and the occlusion rate of the great saphenous vein (GSV) 12 months after surgery. METHODS: Patients with symptomatic, uncomplicated varicose veins (CEAP class C2-C4) were examined at baseline, 1 month and 1 year...
October 2016: British Journal of Surgery
Davide Ippolito, Chiara Trattenero, Cammillo Talei Franzesi, Alessandra Casiraghi, Sophie Lombardi, Francesco Vacirca, Rocco Corso, Sandro Sironi
PURPOSE: The aim of this study was to investigate the role of dynamic contrast-enhanced magnetic resonance imaging (MRI) in evaluation of blood flow changes related to transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) procedures in patients with hepatocellular carcinoma (HCC) lesions. METHODS: Fifty-four patients, with biopsy-proven HCC, who underwent TACE or RFA, were evaluated, 1 month after treatment, with upper abdominal MRI examination...
September 2016: Journal of Computer Assisted Tomography
Diego Ayo, Sheila N Blumberg, Caron R Rockman, Mikel Sadek, Neal Cayne, Mark Adelman, Lowell Kabnick, Thomas Maldonado, Todd Berland
OBJECTIVE: The goal of this study is to determine if compression therapy after endovenous ablation (EVA) of the great saphenous vein (GSV) improves efficacy and patient reported outcomes of pain, ecchymosis and quality of life. METHODS: This was a prospective randomized controlled trial from 2009 to 2013 comparing the use of thigh-high 30-40mmHg compression therapy for 7 days vs no compression therapy following endovenous ablation of the GSV. Severity of venous disease was measured by CEAP scale and the venous clinical severity score (VCSS)...
August 20, 2016: Annals of Vascular Surgery
Clement C M Leung, Daniel Carradice, Tom Wallace, Ian C Chetter
BACKGROUND: Endovenous thermal techniques, such as endovenous laser ablation (EVLA), are the recommended treatment for truncal varicose veins. However, a disadvantage of thermal techniques is that it requires the administration of tumescent anaesthesia, which can be uncomfortable. Non-thermal, non-tumescent techniques, such as mechanochemical ablation (MOCA) have potential benefits. MOCA combines physical damage to endothelium using a rotating wire, with the infusion of a liquid sclerosant...
2016: Trials
Jeffrey Harris, Hani Almarzouki, Brittany Barber, Rufus Scrimger, Jacques Romney, Daniel O'Connell, Mark Urken, Hadi Seikaly
PURPOSE: The incidence of hypothyroidism after radiation therapy for head and neck cancer (HNC) has been found to be ≤53%. Medical treatment of hypothyroidism can be costly and difficult to titrate. The aim of the present study was to assess the feasibility of free thyroid transfer as a strategy for the prevention of radiation-induced damage to the thyroid gland during radiation therapy for HNC. METHODS AND MATERIALS: A prospective feasibility study was performed involving 10 patients with a new diagnosis of advanced HNC undergoing ablative surgery, radial forearm free-tissue transfer reconstruction, and postoperative adjuvant radiation therapy...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
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