Venous Thermal Ablation

OBJECTIVE: Subependymal giant cell astrocytomas (SEGAs) are WHO grade 1 tumors associated with tuberous sclerosis that classically arise from the ventricular wall near the caudate groove and foramen of Monro. Laser interstitial thermal therapy (LITT) is a minimally invasive surgical technique, which works by heating a stereotactically placed laser fiber to ablative temperatures under MRI thermometry monitoring. In this paper, the authors present LITT as a surgical alternative to open resection of SEGAs...

Primary aldosteronism (PA) is the most prevalent form of secondary hypertension and is most commonly caused by an adrenal adenoma or bilateral adrenal hyperplasia. Minimally invasive adrenalectomy is the treatment of choice for unilateral disease. Here, we report the case of a 57-year-old man with previous bladder cancer who was referred for evaluation of resistant hypertension and hypokalemia. Diagnostic workup indicated PA with computed tomography imaging revealing a left adrenal adenoma and adrenal venous sampling lateralizing to the left adrenal...

BACKGROUND: Chronic venous disease is a frequent and prevalent pathology. Its surgical treatment has been shown to be cost-effective. Thermal endoablation performed as major outpatient surgery (MAS) is the technique of choice. OBJECTIVE: To know the satisfaction of patients after MAS and the quality of care provided. METHOD: Observational, descriptive, cross-sectional study, carried out between January 2019 and March 2020. A survey was carried out on patients who underwent endovascular radiofrequency thermoablation in two hospitals in Spain, consisting of two questionnaires: one ad hoc and one another of satisfaction (SERCAL)...

BACKGROUND: For patients with varicose veins, the goal is to relieve pain and swelling, reduce the severity of edema, improve skin changes, and heal ulcers associated with venous disease. Compression therapy is the cornerstone of their management. Several studies have shown that wearing an elastic bandage for the first 24 h and then a compression stocking for a week can effectively reduce the pain after thermal ablation. However, in clinical practice, patient compliance with this treatment could be better, considering difficulties in pulling up and removing the compression stocking, tightness, and skin irritation because these must be worn for a prolonged period...

OBJECTIVE: Patient characteristics and risk factors for incomplete or non-closure following thermal saphenous vein ablation have been reported. However, similar findings have not been clearly described following commercially manufactured polidocanol microfoam ablation (MFA). The objective of our study is to identify predictive factors and outcomes associated with non-closure following MFA of symptomatic, refluxing saphenous veins. METHODS: A retrospective review of a prospectively maintained patient database was performed from procedures in our Ambulatory Procedure Unit...

OBJECTIVE: To summarize the existing evidence for the treatment of saphenous veins >10 mm in diameter, determine whether there were vein size limits for treatment modalities and if there are specific technical considerations for treatment of large veins. METHODS: We searched the literature for reports of treatment methods and outcomes for patients with large-diameter saphenous veins treated with various ablation methods between 1993 and 2023. These studies were evaluated for the size of the vein determined as "large diameter," type of ablation method, study type, outcomes, adverse events, and any technical considerations noted...

OBJECTIVE: Recanalization of the saphenous vein trunk after endovenous radiofrequency ablation (RFA) is often associated with recurrent varicose veins or similar. This study aimed to assess the long-term results of RFA of the great saphenous vein (GSV) and identify risk factors for GSV recanalization and RVVs over the follow-up in patients presenting to dedicated outpatient vein centers. METHODS: All consecutive patients with incompetent GSV who underwent RFA between 2009 and 2019 were retrospectively analyzed...

BACKGROUND: Endovenous thermal ablation (EVTA) of the lower extremity veins has risen to become the main treatment modality for symptomatic venous reflux disease. One of the main reported side effects of EVTA is recanalization. As of today, there is no clear protocol as to when follow-up duplex ultrasound scans should be performed. However, the standard for postoperative duplex after truncal ablation is within one week of the procedure. Our aim is to try to find whether there is a particular time period when post-operative duplex ultrasound scans should be performed to allow us to best diagnose recanalization...

OBJECTIVE: Endovenous microwave ablation (EMA) is a recently developed thermal ablation technique used in the treatment of lower limb varicose veins. However, its efficacy and safety have been largely understudied. In the present study, we sought to explore the clinical results of EMA and radiofrequency ablation (RFA) in treating lower limb varicose veins. METHODS: Patients who underwent EMA (n = 65) or RFA (n = 46) at our institute from September 2018 to September 2020 were included in this retrospective investigation...

BACKGROUND: Pulsed field ablation (PFA) is a non-thermal energy source with promising safety and efficacy advantages. We aimed to develop a convenient, safe, effective and fast method of pulmonary vein isolation (PVI) utilizing a penta-spline PFA catheter via a single femoral vein and a venous closure system.Methods and Results: Consecutive patients (n=50; mean age: 63.6±10.7 years, 38% female) presenting with AF (paroxysmal AF: 56%) underwent first-time PVI via PFA...

Endovenous thermal methods are superseding surgical stripping for treating chronic superficial venous disease but require tumescent anesthesia and can cause heat-related nerve injuries. Endovenous cyanoacrylate ablation is a more recent technique that does not share these drawbacks. A retrospective observational study of consecutive adults managed with endovenous cyanoacrylate was conducted in 2018-2021 at a single university center. The follow-up was 18 months. We identified factors associated with target vein closure at 18 months and measured changes in quality of life using the generic 36-item Short-Form (SF-36) tool and the venous disease-specific VEINES-QOL/Sym questionnaire...

BACKGROUND: We sought to assess the safety and efficacy of endovenous thermal ablation (EVTA) in treating large great saphenous veins (GSV) > 12 mm in diameter. METHODS: We performed a systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 for comparative and noncomparative studies depicting EVTA in the treatment of GSV > 12 mm. Primary endpoints included GSV occlusion, technical success, deep vein thrombosis (DVT), and endovenous heat-induced thrombosis (EHIT)...

OBJECTIVE: The reflux pathophysiology of the saphenofemoral junction (SFJ) of the insufficient great saphenous vein (GSV) has already been investigated and stratified. These results are still lacking for the small saphenous vein (SSV). The aim of the study was to analyze the pathophysiology of the saphenopopliteal junction (SPJ) in case of refluxing SSV. METHODS: The study included 1142 legs investigated between 4/1/2019 to 2/15/2023 with chronic venous insufficiency scheduled for endoluminal thermal ablation of the insufficient SSV...

BACKGROUND: Sclerotherapy is among the mainstays of chronic venous disease treatment, yet its occlusion rate remains suboptimal compared to thermal tumescent techniques. An innovative three-balloons catheter has been developed to allow sclerotherapy in empty vein conditions (empty vein ablation technique, EVA). Aim of this investigation was to describe the EVA technical aspects and related ex-vivo effects on vein wall. METHODS: Two samples from jugular veins of an adult sheep were treated by EVA or foam sclerotherapy (FS, Tessari method)...

INTRODUCTION: Doctors have a legal requirement and duty of care to ensure patients are enabled to make an informed decision about their treatment, including discussion of the benefits, risks and alternatives to a procedure. A patient-centred approach to consent has been firmly established in Ireland, and fundamental to this is the ability to engage in a dialogue that offers comprehensible information to patients. Telemedicine has revolutionised the way we can deliver care to patients in the modern era of computers, tablets, and smartphones, and its use has been rapidly expanded...

<b/> Background: Traditionally, varicose vein treatment is predominately performed during the colder seasons. However, data whether higher outdoor temperatures affect the outcome and/or complication rate of endovenous thermal ablation (ETA) for treatment of symptomatic varicose veins are missing. Patients and methods: In this observational study, the medical records of all patients who had ETA of the great saphenous vein (GSV), accessory saphenous vein (ASV), or small saphenous vein (SSV) between September 2017 and October 2020 were reviewed...

Varicose veins of the lower extremities are a very common condition in vascular surgery. With advances in technology and medicine, minimally invasive endovenous thermal ablation has become the primary approach used to treat patients with moderate or severe varicose veins. Electrocoagulation for thermal ablation is a relatively simple and economical procedure, but standards vary according to location and some limitations exist. We report a case of a 58-year-old female patient with small saphenous varicose veins in the right lower extremity in which an electrocoagulation rod commonly used in laparoscopic surgery was innovatively used instead of a standard variable electrocoagulation device...

OBJECTIVE: The objective was to compare technical success, complications, and quality of life after thermal vs. non-thermal endovenous ablation for the treatment of superficial venous incompetence. DATA SOURCES: Electronic bibliographic sources (Google Scholar, Pubmed, Cochrane Database, Scopus, Web of Science, and Embase). REVIEW METHODS: A systematic review and meta-analysis of randomised controlled trials was conducted using terms to identify relevant studies to be included...

OBJECTIVES: Radiofrequency-based procedure is one of the leading methods of endovenous thermal ablation. The most fundamental difference with regards to currently available radiofrequency ablation systems is the way of electric current flow given to the vein wall; bipolar segmental and monopolar ablation. This study aimed to compare the monopolar ablation method with conventional bipolar segmental endovenous radiofrequency ablation method for the management of incompetent saphenous veins...

OBJECTIVES: To assess the mid-term efficacy and safety of thermal and non-thermal endovenous ablation in the treatment of lower limb superficial venous insufficiency. METHOD: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and a Bayesian network meta-analysis. Primary endpoints were great saphenous vein (GSV) closure and venous clinical severity score (VCSS) score improvement...