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Endovenous ablation venous ulcer

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...
April 10, 2017: European Journal of Vascular and Endovascular Surgery
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)...
January 31, 2017: International Angiology: a Journal of the International Union of Angiology
Sharath Chandra Vikram Paravastu, Margaret Horne, P Dominic F Dodd
BACKGROUND: Short (or small) saphenous vein (SSV) varices occur as a result of an incompetent sapheno-popliteal junction, where the SSV joins the popliteal vein, resulting in reflux in the SSV; they account for about 15% of varicose veins. Untreated varicose veins may sometimes lead to ulceration of the leg, which is difficult to manage. Traditionally, treatment was restricted to surgery or conservative management. Since the 1990s, however, a number of minimally invasive techniques have been developed; these do not normally require a general anaesthetic, are day-case procedures with a quicker return to normal activities and avoid the risk of wound infection which may occur following surgery...
November 29, 2016: Cochrane Database of Systematic Reviews
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
Diego Ayo, Sheila N Blumberg, Caron R Rockman, Mikel Sadek, Neal Cayne, Mark Adelman, Lowell Kabnick, Thomas Maldonado, Todd Berland
BACKGROUND: 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 is a prospective randomized controlled trial from 2009 to 2013 comparing the use of thigh-high 30-40 mm Hg compression therapy for 7 days versus no compression therapy following EVA of the GSV. Severity of venous disease was measured by clinical severity, etiology, anatomy, pathophysiology scale and the Venous Clinical Severity Score (VCSS)...
January 2017: Annals of Vascular Surgery
Ashley Wysong, Brent R Taylor, Michael Graves, Vineet Mishra, Ryan Gilbertson, Hubert T Greenway, Leland Housman
BACKGROUND: Venous ulcers are very common with few curative treatment options. OBJECTIVE: To report the closure rate and clinical characteristics of active venous ulcers in a vein clinic using endovenous laser ablation (EVLA) with a 1,320-nm laser. METHODS AND MATERIALS: A prospective database was kept consisting of patients with an active venous ulcer at the time of consultation in a single-practitioner academic vein clinic from March 2007 to May 2014...
August 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Seshadri Raju, Fedor Lurie, Thomas F O'Donnell
BACKGROUND: Compression has long been the mainstay of treatment in chronic venous disease (CVD). The current treatment paradigm emphasizes compression as primary treatment, awarding saphenous ablation only an optional role. The advent of endovenous interventions, such as endovenous ablation (EVA) of the saphenous vein and iliac vein stenting, has dramatically expanded therapeutic options. The relative roles of the old and newer techniques are in a state of flux and need to be redefined...
July 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Elrasheid A H Kheirelseid, Khalid Bashar, Thomas Aherne, Thamir Babiker, Peter Naughton, Daragh Moneley, Stewart R Walsh, Austin L Leahy
BACKGROUND: Venous leg ulcers affect 1-3% of adults with a significant economic impact, utilizing 1% of annual healthcare budgets in some western European countries. OBJECTIVES: To determine the effects of intervention for incompetent superficial veins on ulcer healing and recurrence in patients with active or healed venous ulcers. SEARCH METHODS: In October 2014, we searched Medline, CINAHL, EMBASE, Scopus, the Cochrane library and Web of Science without date or language restriction for relevant randomized or observational studies...
August 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Minyi Yin, Xintian Huang, Chaoyi Cui, Kaichuang Ye, Weimin Li, Xinwu Lu, Min Lu, Mier Jiang
OBJECTIVE: The current study aimed to determine whether it is necessary to correct May-Thurner syndrome (MTS) simultaneously with superficial venous reflux disease (S-VRD) in limbs of combined symptomatic MTS/S-VRD. METHODS: A retrospective analysis of patients with S-VRD combined with MTS was conducted in a single institution from January 2001 to December 2010. Doppler ultrasound and phlebography were performed in patients with VRD. Computed tomography angiography or transfemoral venography was selectively performed in patients with severe symptoms or findings on phlebography suggestive of MTS...
April 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Himanshu Verma, Ramesh K Tripathi
Management of venous ulceration has evolved tremendously during the last 2 decades. There has been considerable progress in our understanding of the pathophysiology, hemodynamics, venous imaging, and therapeutic options for venous ulcers, including endovenous ablation, iliac vein stenting, and vein-valve repair techniques. Details of these procedures are described in this issue of Seminars. With so many permutations and combinations of venous disease, including superficial and deep vein abnormalities, that produce venous ulceration, as well as a plethora of diagnostic and therapeutic tools at our disposal, it is important to have an algorithm for venous ulcer management...
March 2015: Seminars in Vascular Surgery
Briony F Hudson, Jade Davidson, Mark S Whiteley
BACKGROUND: Elevated patient anxiety during surgery is linked to a range of suboptimal treatment outcomes. Reflexology has been reported to be effective in reducing pre and post-operative anxiety and post-operative pain. OBJECTIVES: To explore whether the addition of hand reflexology to treatment as usual during minimally invasive varicose vein surgery under local anaesthetic impacted upon patient reported anxiety and pain during surgery, and patient satisfaction with treatment...
December 2015: International Journal of Nursing Studies
Mustafa Seren, Mert Dumantepe, Osman Fazliogullari, Suha Kucukaksu
OBJECTIVE: Patients with healed venous ulcers often experience recurrence of ulceration, despite the use of long-term compression therapy. This study examines the effect of closing incompetent perforating veins (IPVs) on ulcer recurrence rates in patients with progressive lipodermatosclerosis and impending ulceration. METHODS: Patients with nonhealing venous ulcers of >2 months' duration underwent duplex ultrasound to assess their lower extremity venous system for incompetence of superficial, perforating, and deep veins...
June 30, 2015: Phlebology
Marianne E Witte, Michel M P J Reijnen, Jean-Paul de Vries, Clark J Zeebregts
INTRODUCTION: In the last decade, minimally invasive endothermal ablation techniques have replaced surgery for the treatment of superficial venous insufficiency to reduce postoperative complications and recovery time and to improve quality of life. To avoid the risks of nerve damage and need for tumescent anesthesia to improve patient comfort, an alternative heatless technique has been introduced recently. METHODS: Endovenous mechanochemical occlusion using the ClariVein® catheter (Vascular Insights LLC, Quincy, MA) is a new technique combining mechanical injury to the venous endothelium coupled with simultaneous catheter-guided infusion of a liquid sclerosant...
May 2015: Surgical Technology International
Maciej Chwała, Wojciech Szczeklik, Michał Szczeklik, Tomasz Aleksiejew-Kleszczyński, Maria Jagielska-Chwała
Chronic venous insufficiency is one of the most common disorders of the vascular system, affecting approximately 50% of adults. If left untreated it can lead to a number of complications, including venous ulceration and venous thrombosis. This review paper outlines the epidemiology and ethiopathogenesis of the disease with regard to hemodynamics and microcirculation disturbances. It describes the medical treatment as well as the traditional surgical approach to varicose veins (with several modifications of this technique), and its limitations and contraindications...
January 2015: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
M Beyazal, S Avcu, Ö Özen, A Yavuz, A Bora, Ö Ünal
OBJECTIVE: Superficial venous insufficiency is a common problem associated with varicose veins which, if untreated, may progress to venous ulceration. Endovenous laser ablation (EVLA) is a new, minimally invasive method for management of superficial venous insufficiency and varicose veins. The aim of this study was to demonstrate the effectiveness of 980 nm EVLA for treatment of symptomatic saphenous venous insufficiency and to present its early outcomes. METHODS: Thirty-eight great saphenous veins and 5 small saphenous veins in 40 patients with saphenofemoral reflux were treated with 980 nm diode endovenous laser equipment...
November 2014: JBR-BTR: Organe de la Société Royale Belge de Radiologie (SRBR)
H Shi, X Liu, M Lu, X Lu, M Jiang, M Yin
OBJECTIVE/BACKGROUND: This study aimed to investigate the clinical results and fate of incompetent perforating veins (IPVs) following treatment of superficial venous insufficiency, with or without endovenous laser ablation (EVLA) of IPVs. METHODS: A retrospective analysis of patients with primary venous insufficiency (PVI) was conducted in a single institution from January, 2010 to December, 2011. IPVs were found in 311 patients (376 limbs). Among these, 132 patients (156 limbs) were treated with EVLA of IPVs and varicose vein surgery, and the remaining 179 patients (220 limbs) were treated with varicose vein surgery alone and served as controls...
May 2015: European Journal of Vascular and Endovascular Surgery
Thomas N Carruthers, Alik Farber, Denis Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: To evaluate patient characteristics, practice patterns, and outcomes for patients treated for chronic venous insufficiency (CVI). BACKGROUND: Chronic venous insufficiency is a common problem treated using open or endovascular methods by physicians from a number of surgical and nonsurgical specialties. METHODS: Patients treated for CVI in the American College of Surgeons National Surgical Quality Improvement Program data set (2005-2011) were identified...
October 2014: Vascular and Endovascular Surgery
Avianne P Bunnell, Shariq Zaidi, J Leigh Eidson, W Todd Bohannon, Marvin D Atkins, Ruth L Bush
BACKGROUND: Endovenous thermal ablation has emerged as an alternative therapy for the treatment of chronic superficial venous insufficiency (CVI) of the lower extremities. Recanalization, or anatomic failure, of a vein after endovenous radiofrequency ablation (RFA) has been described, albeit an infrequent occurrence. This study was performed to demonstrate risk factors associated with the efficacy of RFA and recanalization in the treatment of CVI. METHODS: Data were collected in an ongoing multicenter registry, which was retrospectively reviewed...
February 2015: Annals of Vascular Surgery
Ilhan Golbasi, Cengiz Turkay, Ozan Erbasan, Cemal Kemaloğlu, Suat Sanli, Mehtap Turkay, Ömer Bayezid
Varicose veins, associated with great saphenous vein (GSV) incompetence, are traditionally treated with conventional surgery. In recent years, minimally invasive alternatives to surgical treatment such as the endovenous laser ablation (EVLA) and radiofrequency (RF) ablation have been developed with promising results. Residual varicose veins following EVLA, regress untouched, or phlebectomy or foam sclerotherapy can be concomitantly performed. The aim of the present study was to investigate the safety and efficacy of EVLA with different levels of laser energy in patients with varicose veins secondary to saphenous vein reflux...
January 2015: Lasers in Medical Science
Rei Kansaku, Naoki Sakakibara, Atsushi Amano, Hisako Endo, Takashi Shimabukuro, Michiaki Sueishi
BACKGROUND: Endovenous laser ablation to saphenous veins has been popular as a minimally invasive treatment for chronic venous insufficiency. However, adverse effects after endovenous laser ablation using continuous wave laser still remain. Pulsed wave with enough short pulse duration and sufficiently long thermal relaxation time may avoid the excess energy delivery, which leads to the perforation of the vein wall. METHOD: (1) Free radiation: Laser is radiated in blood for 10 s...
July 2015: Phlebology
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