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Venous Thermal Ablation

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https://www.readbyqxmd.com/read/27898181/endovenous-ablation-therapy-laser-or-radiofrequency-or-foam-sclerotherapy-versus-conventional-surgical-repair-for-short-saphenous-varicose-veins
#1
REVIEW
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
https://www.readbyqxmd.com/read/27727418/nya-behandlingar-av-%C3%A3-derbr%C3%A3-ck-med-goda-resultat
#2
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
https://www.readbyqxmd.com/read/27688037/hydrodisplacement-of-sural-nerve-for-safety-and-efficacy-of-endovenous-thermal-ablation-for-small-saphenous-vein-incompetence
#3
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
https://www.readbyqxmd.com/read/27552990/endovenous-laser-ablation-versus-mechanochemical-ablation-with-clarivein-%C3%A2-in-the-management-of-superficial-venous-insufficiency-lama-trial-study-protocol-for-a-randomised-controlled-trial
#4
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...
August 24, 2016: Trials
https://www.readbyqxmd.com/read/27507115/endoluminal-application-of-glass-capped-diffuser-for-ex-vivo-endovenous-photocoagulation
#5
Minwoo Ahn, Yu-Gyeong Chae, Jieun Hwang, Yeh-Chan Ahn, Hyun Wook Kang
Endovenous laser ablation (EVLA) has frequently been used to treat varicose veins for 20 years. In spite of 90˜95% occlusion rates, clinical complications such as burn and ecchymosis still occur due to excessive thermal injury to perivenous tissue. In the current study, a glass-capped diffusing applicator is designed to validate the feasibility of EVLA as an effective therapeutic device by applying circumferential light distribution. The proposed device is evaluated with a flat fiber as a reference in terms of temperature elevation, fiber degradation, and degree of coagulative necrosis after 532 nm-assisted EVLA at 100 J/cm...
August 10, 2016: Journal of Biophotonics
https://www.readbyqxmd.com/read/27181398/interventions-for-varicose-veins-beyond-ablation
#6
REVIEW
Raghu Kolluri
Minimally invasive endothermal treatments have replaced surgical ligation and stripping in the management of chronic venous insufficiency (CVI) and are now considered the standard of care. Newer techniques have emerged in the last few years in an attempt to further minimize the procedural discomfort associated with endothermal procedures. These new techniques are designed to avoid tumescent anesthesia (TA). These new non-thermal, tumescentless techniques are well tolerated and are shown to result in equivalent outcomes when compared to the thermal ablations...
July 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27129070/n-butyl-cyanoacrylate-in-the-treatment-of-venous-insufficiency-the-effect-of-embolisation-with-ablative-polymerisation
#7
MULTICENTER STUDY
Eyüp Serhat Çalık, Ümit Arslan, Fırat Ayaz, Mehmet Tort, Ziya Yıldız, Volkan Aksu, Oruç Alper Onk, Hüsnü Kamil Limandal, Evren Ekingen, Özgür Dağ, Mehmet Ali Kaygın, Bilgehan Erkut
BACKGROUND: The primary objective of this multicentre prospective observational study was to evaluate the early results of a new non-thermal embolisation method using N-butyl cyanoacrylate in venous insufficiency. PATIENTS AND METHODS: A total of 181 patients with a varicose vein diagnosis were treated with the VariClose: Vein Sealing Systems at four different centres. The protocol included physical and colour Doppler ultrasonography examination, venous clinical severity score and quality of life assessment before and after the procedure on days 1 and 7 and at months 1, 3 and 6...
2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/26994834/predictors-of-recanalization-of-the-great-saphenous-vein-in-randomized-controlled-trials-1-year-after-endovenous-thermal-ablation
#8
S K Van der Velden, M Lawaetz, M G R De Maeseneer, L Hollestein, T Nijsten, R R van den Bos
OBJECTIVE/BACKGROUND: The objective was to identify predictors to develop and validate a prognostic model of recanalization of the great saphenous vein (GSV) in patients treated with endovenous thermal ablation (EVTA). METHODS: The search strategy of Siribumrungwong was updated between August 2011 and August 2014 using MEDLINE, Embase, and the Cochrane register to identify randomized controlled trials (RCTs), in which patients presenting with GSV reflux were treated with radiofrequency or endovenous laser ablation...
August 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/26993692/efficacy-of-endovenous-ablation-of-the-saphenous-veins-for-prevention-and-healing-of-venous-ulcers
#9
William A Marston
In many countries, endovenous ablation (EVA) has replaced surgical stripping as the preferred method of eliminating saphenous reflux in symptomatic patients. Studies have examined the success of EVA at saphenous closure and improving leg pain and edema. However, less information is available on the ability of these techniques to promote venous leg ulcer healing or to prevent recurrence. The comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR) trial identified the role of saphenous stripping in reducing the rate of ulcer recurrence after healing, supporting this procedure for Clinical, Etiologic, Anatomic, and Pathologic (CEAP) clinical class 5 and 6 patients...
January 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26993677/assessment-of-thrombotic-adverse-events-and-treatment-patterns-associated-with-varicose-vein-treatment
#10
Thomas F O'Donnell, Michael Eaddy, Aditya Raju, Kimberly Boswell, David Wright
OBJECTIVE: This retrospective study assessed varicose vein treatment patterns and associated thrombotic complications in a real-world setting. METHODS: A retrospective study was conducted with health care claims data from Truven Health, covering more than 40 million insured lives per year and representing all U.S. census regions. The study sample included subjects aged ≥ 18 years with a new diagnosis of varicose veins who had received at least one invasive treatment (eg, surgery, endovenous thermal ablation [radiofrequency or laser], or sclerotherapy [liquid or foam])...
January 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26992336/pretreatment-elevated-d-dimer-levels-without-systemic-inflammatory-response-are-associated-with-thrombotic-complications-of-thermal-ablation-of-the-great-saphenous-vein
#11
Fedor Lurie, Robert L Kistner
OBJECTIVE: To examine possible association of plasma levels of biomarkers of inflammation and hemostatic activation with the incidence of thrombotic complications after thermal ablation of the great saphenous vein (GSV). METHODS: This was a prospective cohort study of 120 patients with primary chronic venous disease and reflux limited to the GSV and its tributaries, who were to undergo treatment with radiofrequency ablation of the GSV. Plasma concentration of C-reactive protein (high-sensitivity CRP) and D-dimer were measured immediately prior to the ablation procedure, and in 64 patients, at 20 to 36 hours, 1 week, and 1 month after the treatment...
April 2013: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26957489/a-multicenter-randomized-placebo-controlled-trial-of-endovenous-thermal-ablation-with-or-without-polidocanol-endovenous-microfoam-treatment-in-patients-with-great-saphenous-vein-incompetence-and-visible-varicosities
#12
Michael Vasquez, Antonios P Gasparis
OBJECTIVES: *Varithena 017 Investigator Group: Michael Vasquez, MD, Venous Institute of Buffalo, Amherst, NY; Antonios Gasparis, MD, Stony Brook University Medical Center, Stony Brook, NY; Kathleen Gibson, MD, Lake Washington Vascular, Bellevue, WA; James Theodore King, MD, Vein Clinics of America, Oakbrook Terrace, IL; Nick Morrison, MD, Morrison Vein Institute, Scottsdale, AZ; Girish Munavalli, MD, Dermatology, Laser & Vein Specialists of the Carolinas, Charlotte, NC; Eulogio J. Sanchez, MD, Batey Cardiovascular Center, Bradenton, FL...
March 7, 2016: Phlebology
https://www.readbyqxmd.com/read/26946910/current-state-of-the-treatment-of-perforating-veins
#13
Ellen D Dillavou, Michael Harlander-Locke, Nicos Labropoulos, Steven Elias, Kathleen J Ozsvath
Perforating veins may play a role in the development of chronic venous insufficiency and ulceration. There is renewed interest in minimally invasive treatments vs historic surgical options. Current indications for treatment, technical success, and evidence for clinical efficacy are summarized. Existing recommendations include perforator closure in Clinical, Etiology, Anatomy, and Pathophysiology class 5 or class 6 disease through percutaneous thermal ablation, subfascial endoscopic perforator surgery, open surgery, or sclerotherapy...
January 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26715372/cost-effectiveness-of-radiofrequency-ablation-versus-laser-for-varicose-veins
#14
Amanda C Shepherd, Marta Ortega-Ortega, Manj S Gohel, David Epstein, Louise C Brown, Alun H Davies
OBJECTIVES: Although the clinical benefits of endovenous thermal ablation are widely recognized, few studies have evaluated the health economic implications of different treatments. This study compares 6-month clinical outcomes and cost-effectiveness of endovenous laser ablation (EVLA) compared with radiofrequency ablation (RFA) in the setting of a randomized clinical trial. METHODS: Patients with symptomatic primary varicose veins were randomized to EVLA or RFA and followed up for 6 months to evaluate clinical improvements, health related quality of life (HRQOL) and cost-effectiveness...
January 2015: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/26648666/significance-of-reflux-abolition-at-the-saphenofemoral-junction-in-connection-with-stripping-and-ablative-methods
#15
REVIEW
Cestmir Recek
Saphenous reflux interferes with the physiological decrease in pressure and induces ambulatory venous hypertension. Elimination of reflux is achieved by flush ligation at the incompetent saphenofemoral junction and stripping of the great saphenous vein, which is the basis of the conventional surgical therapy. Endovenous ablative methods substitute stripping by thermal of chemical destruction of the saphenous trunk; they usually refrain from saphenofemoral junction ligation. Short-term and medium-term results up to 5 years, achieved after endovenous ablation without high ligation, are comparable with those after conventional surgery, which questioned the necessity to ligate the incompetent saphenofemoral junction...
December 2015: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/26602850/-prevention-of-postthrombotic-syndrom
#16
REVIEW
Ulrike Hügel, Iris Baumgartner
Post-thrombotic syndrome (PTS) is a complication which occurs after deep vein thrombosis in spite of optimal anticoagulation. The term ’post-thrombotic syndrome’ summarizes all clinical symptoms and skin lesions developing in the aftermath of deep vein thrombosis. In order to prevent PTS various therapeutic options exist, the choice is depending on the time lapse since the event of thrombosis. At the acute phase of pelvic vein thrombosis catheter-directed lysis has proved to be an efficient therapy. Starting from the acute phase up to the chronic phase compression therapy should be administered...
November 25, 2015: Praxis
https://www.readbyqxmd.com/read/26564912/treatment-modalities-for-small-saphenous-vein-insufficiency-systematic-review-and-meta-analysis
#17
REVIEW
Doeke Boersma, Verena N N Kornmann, Ramon R J P van Eekeren, Ellen Tromp, Çagdas Ünlü, Michel M J P Reijnen, Jean-Paul P M de Vries
PURPOSE: To investigate and compare the anatomical success rates and complications of the treatment modalities for small saphenous vein (SSV) incompetence. METHODS: A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library on the following therapies for incompetence of SSVs: surgery, endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), steam ablation, and mechanochemical endovenous ablation (MOCA)...
February 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/26556699/glue-steam-and-clarivein-best-practice-techniques-and-evidence
#18
REVIEW
Mark S Whiteley
In July 2013, the National Institute of Health and Clinical Excellence (NICE) recommended "endothermal" ablation (meaning endovenous thermal ablation) is the first line treatment for truncal venous reflux in varicose veins. The initial endovenous thermoablation devices were radiofrequency ablation and endovenous laser ablation. More recently, Glue (cyanoacrylate), endovenous steam and Clarivein (mechanochemical ablation or MOCA) have entered the market as new endovenous techniques for the treatment of varicose veins...
November 2015: Phlebology
https://www.readbyqxmd.com/read/26365546/irreversible-electroporation-for-colorectal-liver-metastases
#19
REVIEW
Hester J Scheffer, Marleen C A M Melenhorst, Ana M Echenique, Karin Nielsen, Aukje A J M van Tilborg, Willemien van den Bos, Laurien G P H Vroomen, Petrousjka M P van den Tol, Martijn R Meijerink
Image-guided tumor ablation techniques have significantly broadened the treatment possibilities for primary and secondary hepatic malignancies. A new ablation technique, irreversible electroporation (IRE), was recently added to the treatment armamentarium. As opposed to thermal ablation, cell death with IRE is primarily induced using electrical energy: electrical pulses disrupt the cellular membrane integrity, resulting in cell death while sparing the extracellular matrix of sensitive structures such as the bile ducts, blood vessels, and bowel wall...
September 2015: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/26355925/-effect-of-pharmacotherapy-on-course-of-postoperative-period-after-endovenous-thermal-ablation
#20
Yu M Stoiko, K V Mazaishvili, T V Khlevtova, A V Tsyplyashchuk, S E Kharitonova, S S Akimov
The authors assessed the effect of a micronized purified flavonoid fraction (MPFF) on the course of the postoperative period after endovenous thermal ablation (EVTA). The patients of the Study Group matching by the main studied parameters to the Control Group patients were given the MPFF according to the suggested regimen for 7 days. The obtained results were analysed by means of questionnaires (CIVIQ, VCSS, VAS) and ultrasound angioscanning. The obtained findings were statistically processed by means of the program Statistica 6...
2015: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
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