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Jamie Vatish, Nusrat Iqbal, Viswa Retnasingam Rajalingam, Alok Tiwari
OBJECTIVES: The purpose of this study was to evaluate whether anticoagulation (warfarin or direct oral inhibitors) affected the success of endovenous treatment. METHODS: Patients taking anticoagulation (warfarin or direct oral inhibitors) undergoing endovenous treatment in the form of endovenous laser ablation (EVLA) were matched against controls for sex, age, leg, and vein. Data were collected prospectively between January 2012 and March 2017. The primary endpoint was failure of treatment at 6-week postoperative duplex scan...
January 1, 2018: Vascular and Endovascular Surgery
Hisanao Hazama, Masato Yoshimori, Norihiro Honda, Kunio Awazu
Background and aims: Endovenous laser ablation (EVLA) has been well-reported as a minimally invasive method to deal with varices of the lower extremities. The lasers used fall into two categories: pigment, i.e., hemoglobin-specific lasers in the visible and near-infrared (near-IR) wavebands and longer wavelength mid-infrared lasers where the chromophore is water. The fiber used to deliver the laser energy is also important, and not enough attention has been paid to this element of EVLA...
December 31, 2017: Laser Therapy
James A Lawson, Stefanie A Gauw, Clarissa J van Vlijmen, Pascal Pronk, Menno T W Gaastra, Marco J Tangelder, Michael C Mooij
BACKGROUND: Endovenous laser ablation (EVLA) and radiofrequency-powered segmental ablation (RPSA) of the incompetent great saphenous vein (GSV) are both known for their excellent technical and clinical outcomes for the treatment of varicose veins. RPSA has reduced postprocedural pain and morbidity with shorter recovery time for the patient compared with EVLA using bare-tip fibers. However, new-generation EVLA devices with less traumatic radial-tip fibers (RTFs) operating at longer wavelengths up to 1470 nm also reduce postprocedural pain...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Afsha Aurshina, Enrico Ascher, Jesse Victory, Dmitriy Rybitskiy, Anjeza Zholanji, Natalie Marks, Anil Hingorani
OBJECTIVE: Endovenous thermal ablation has become the primary modality of treatment for patients with venous insufficiency. Previous literature has provided reviews of radiofrequency ablation (RFA) or endovenous laser ablation (EVLA) that mostly focus on the great saphenous vein (GSV) and small saphenous vein (SSV). Data with an extended review including the anterior accessory saphenous vein (ASV) and perforator veins (PVs) have been limited. This study examines the treatment of venous insufficiency with RFA and EVLA of these multiple veins to identify clinical and demographic predictors of both the early success and thrombotic complications of endovenous thermal ablation...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Nabil A Al-Zoubi, Rami J Yaghan, Tagleb S Mazahreh, Emad M Hijazi, Ahmad Alqudah, Yasmin N Owaisy, Shadi Hamouri, Nawaf J Al-Shatnawi
OBJECTIVE: To measure pre- and postoperative plasma concentrations of growth factors (VEGF, PDGF, EGF, ANG1, and ANG2) in patients with primary lower limb varicose veins (VVs) treated with endovenous laser ablation (EVLA). BACKGROUND: Many studies have explored the potential relationship between primary VVs and growth factors. No previous studies were done for patients treated with EVLA. MATERIALS AND METHODS: Blood samples were obtained from 30 patients with primary VVs undergoing treatment with EVLA before and 1 week after treatment...
November 27, 2017: Photomedicine and Laser Surgery
Hong H Keo, Frederic Baumann, Nicolas Diehm, Christian Regli, Daniel Staub
OBJECTIVE: Endovenous heat-induced thrombosis (EHIT) and deep venous thrombosis (DVT) are well-known complications after superficial endovenous thermoablation. We investigated the efficacy of rivaroxaban in preventing EHIT and DVT after endovenous laser ablation (EVLA). METHODS: We retrospectively analyzed a consecutive series of patients presenting with truncal varicosis class C2 to C6 undergoing EVLA. After EVLA, all patients received oral rivaroxaban (10 mg) or subcutaneous fondaparinux (2...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Antonio Basile, Alessandro Motta, Giovanni Failla, Giuseppe Caltabiano, Marco Pizzarelli, Cecilia Gozzo, Davide Castiglione, Stefano Palmucci
INTRODUCTION: Varicocele is a relatively complex pathology of the scrotum veins', known to be one of the easiest to treat. Modern treatment involves both surgical (open, laparoscopic and microsurgery) and interventional approach (either with coils and/or sclerosant injection). Our aim is to demonstrate the feasibility and the reliability of endovenous laser ablation (EVLA) of the spermatic vein for the treatment of varicocele. MATERIALS AND METHODS: We consecutively and prospectively treated 11 patients (age range 24-45 years old, mean 31y) with left varicocele, phlebografically classified as Bahren type I and with indication for percutaneous treatment...
2017: European Journal of Radiology Open
Sterre A S Hamann, Jenny Giang, Marianne G R De Maeseneer, Tamar E C Nijsten, Renate R van den Bos
OBJECTIVES: The most frequently used treatment options for great saphenous vein incompetence are high ligation with stripping (HL+S), endovenous thermal ablation (EVTA), mainly consisting of endovenous laser ablation (EVLA) or radiofrequency ablation, and ultrasound guided foam sclerotherapy (UGFS). The objective of this systematic review and meta-analysis was to compare the long-term efficacy of these different treatment modalities. METHODS: A systematic literature search was performed...
December 2017: European Journal of Vascular and Endovascular Surgery
Orhan Bozoglan, Bulent Mese, Erdinc Eroglu, Hasan Cetin Ekerbiçer, Alptekin Yasim
Introduction: To compare endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in different legs in the same individual in patients with venous insufficiency. Methods: Sixty patients with bilateral saphenous vein insufficiency were included. EVLA or RFA was applied to one of the patient's legs and RFA or EVLA to the other leg. Results: EVLA and RFA complications were hyperemia at 20.7% and 31.0%, ecchymosis at 31.0% and 51.7% and edema at 27.6% and 65.5%, respectively. The rate of recanalization was 6...
2017: Journal of Lasers in Medical Sciences
Matheus Bertanha, Marcone Lima Sobreira, Paula Angelelli Bueno Camargo, Rafael Elias Farres Pimenta, Jamil Victor Oliveira Mariúba, Regina Moura, Vanderlei Salvador Bagnato, Winston Bonetti Yoshida
The endovenous laser ablation (EVLA) of the insufficient saphenous vein has similar results to open conventional surgery, but less morbidity. The echo-guided polidocanol foam sclerotherapy technique has been used for the same purpose. The combined techniques may play a role for more severe diseases, such as those with varicose ulcers. An EVLA device (called VELAS) has been developed in the Optics and Photonics Research Center of USP-São Carlos in agreement with FMB-UNESP. In this study, we present the preliminary results of the VELAS device (MMO 980nm diode) in patients with chronic venous ulcer, associated with echo-guided polidocanol foam sclerotherapy for the treatment of varicosities...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
Ümit Arslan, Eyüpserhat Çalık, Mehmet Tort, Ziya Yıldız, Ali İhsan Tekin, Hüsnü Kamil Limandal, Mehmet Ali Kaygın, Özgür Dağ, Bilgehan Erkut
BACKGROUND: Varices and venous insufficiency are common and serious health problems in the general population which affect the quality of life. Endothermal treatment of the great saphenous vein has become the first line of treatment for superficial venous reflux, and the endovenous laser ablation (EVLA) method has been widely accepted all over the world. In this method, ablation is provided by a laser fiber inserted into the lumen of the vein. Initially, the fibers were 810 nm, but today the fibers are usually 940, 980, or 1470 nm...
November 2017: Annals of Vascular Surgery
Heiko Uthoff, Daniel Holtz, Pavel Broz, Daniel Staub, Luca Spinedi
OBJECTIVE: Endovenous heat-induced thrombosis (EHIT) is a well-described complication of endovenous laser ablation (EVLA). We report our centers' experience on the efficacy (EHIT level ≥2 according to the Kabnick classification) and safety (observed major and minor bleeding events) of rivaroxaban for EHIT prophylaxis in EVLA with and without concomitant phlebectomy. METHODS: Demographic, procedural, and outcome data of all patients with EVLA of the great, accessory, or small saphenous vein and EHIT prophylaxis with 10 mg/d rivaroxaban between 2012 and 2014 were reviewed and analyzed in this investigator-initiated multicenter retrospective observational single-arm study...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Kodai Takahashi, Hideto Ito, Toshio Katsube, Masatoshi Hashimoto, Kazuhito Mita, Hideki Asakawa, Takashi Hayashi, Keiichi Fujino
BACKGROUND: The aim of the study was to evaluate the clinical results and postoperative complications, especially recanalization or bleeding complications, in patients with saphenous varicose veins undergoing endovenous laser ablation (EVLA) while receiving antithrombotic therapy (ATT). METHODS: This retrospective cohort study included 1136 Japanese patients undergoing EVLA with a 980-nm diode laser between January 2012 and November 2015 at our institution. The patients were divided into two groups: ATT users (ATT group) and nonusers (control group)...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
H Sinabulya, R Östmyren, L Blomgren
OBJECTIVES: The aim of this study was to assess the mid-term ulcer recurrence rate in patients with healed or active venous ulcers treated with endovenous laser ablation (EVLA) for incompetent superficial axial veins and to search for possible risk factors for non-healing and recurrence. METHODS: Consecutive patients treated with EVLA because of a healed or active venous ulcer between 2006 and 2013 were identified in the medical records and quality registry and invited to follow-up, including clinical history, study examination, Duplex ultrasound scanning, ankle brachial pressure, photoplethysmography, venous clinical severity score (VCSS), and health related quality of life (HRQoL) measured with EQ5D...
May 2017: European Journal of Vascular and Endovascular Surgery
Takeshi Baba, Takao Ohki, Yuji Kanaoka, Koji Maeda, Kenjirou Kaneko, Masayuki Hara, Kota Shukuzawa, Soichiro Fukushima
PURPOSE: To evaluate the efficiency of using the Ginza forceps (DVx, Tokyo, Japan), which have a long shaft and strong grip, for superficial phlebectomy with the stab avulsion technique, during simultaneous endovenous laser ablation (EVLA) of the great saphenous vein (GSV). METHODS: The subjects were patients treated with EVLA performed by a single operator at one institution. All patients had a GSV diameter of 4-10 mm and an EVLA length of the GSV of >20 cm...
April 7, 2017: Surgery Today
Paweł Uruski, Krzysztof Aniukiewicz, Justyna Mikuła-Pietrasik, Patrycja Sosińska, Andrzej Tykarski, Krzysztof Książek, Zbigniew Krasiński
Here we compared effect of serum from varicose patients undergoing endovenous laser ablation (EVLA) and classic vein stripping (CVS) on biological properties of endothelial cells and on the local and systemic profiles of proinflammatory agents. Results showed that serum from EVLA patients improved proliferation and reduced senescence and oxidative stress in the endothelial cells, as compared with the serum from CVS patients. These effects were related to a suppressed activity of TGF-β1, the level of which in the serum from the EVLA patients was decreased...
2017: BioMed Research International
Martin Lawaetz, Julie Serup, Birgit Lawaetz, Lars Bjoern, Allan Blemings, Bo Eklof, Lars Rasmussen
BACKGROUND: This study compares the outcome 5 years after treatment of varicose veins with endovenous radiofrequency ablation (RFA), endovenous laser ablation (EVLA), ultrasound guided foam sclerotherapy (UGFS) or high ligation and stripping (HL/S) by assessing technical efficacy, clinical recurrence and the rate of reoperations. METHODS: Five hundred patients (580 legs) with Great Saphenous Vein (GSV) reflux and varicose veins were randomized to one of the 4 treatments...
June 2017: International Angiology: a Journal of the International Union of Angiology
İsmail Koramaz, Helin El Kılıç, Fatih Gökalp, Macit Bitargil, Nilüfer Bektaş, Ersoy Engin, Mehmet Taşkın Egici, Ahmet Kürşat Bozkurt
OBJECTIVE: The endovenous application of n-butyl cyanoacrylate (NBCA) is a new nontumescent ablation technique for the treatment of venous insufficiency. The aim of this study was to retrospectively compare an NBCA-based ablation method with endovenous laser ablation (EVLA) for the management of incompetent great saphenous veins. METHODS: Between May 2013 and August 2014, there were 339 patients with incompetent varicose veins who were treated with either the endovenous application of NBCA (VariClose Vein Sealing System [VVSS]; Biolas, Ankara, Turkey) or EVLA...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Vladimir Starodubtsev, Mikhail Lukyanenko, Andrey Karpenko, Pavel Ignatenko
BACKGROUND: The aim of study was to estimate the safety and efficacy of using laser wavelength of 1560 nm with the foam sclerotherapy (FS) of varicose veins (VVs) for the treatment of severe primary chronic venous insufficiency (CVI, C4-C6) in patients with different diameters of the proximal segment (DPS) of the great saphenous vein (GSV). METHODS: We have separated the patients into two groups depending on the size of GSV: group 1 (281 cases; DPS of GSV less than 15 mm) and group 2 (210 cases; DPS of GSV more than 15 mm)...
August 2017: International Angiology: a Journal of the International Union of Angiology
Guangzhi He, Chenhong Zheng, Ming-An Yu, Hongpeng Zhang
PURPOSE: To investigate and compare the relative efficacy, recurrence and complications of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) for the treatment of varicose veins patients. METHODS: Searches were applied to the Cochrane Library as well as MEDLINE, EMBASE, BIOSIS databases. 12 articles published in English (10 randomized controlled trials and 2 cohort study) were identified from specialized trails. Fixed effect model and Random effect model were applied to compare the vein ablated length, pain scores (3days and 10days), quality of Life, occlusion, over all complication, thrombophlebitis, haematoma and recanalization between the EVLA and RFA group...
March 2017: International Journal of Surgery
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