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endovenous thermal ablation

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
Kathleen Gibson, Neil Khilnani, Marlin Schul, Mark Meissner
The American College of Phlebology Guidelines Committee performed a systematic review of the literature regarding the clinical impact and treatment of incompetent accessory saphenous veins. Using an accepted process for guideline developments, we developed a consensus opinion that patients with symptomatic incompetence of the accessory great saphenous veins (anterior and posterior accessory saphenous veins) be treated with endovenous thermal ablation (laser or radiofrequency) or ultrasound-guided foam sclerotherapy to eliminate symptomatology (Recommendation Grade 1C)...
October 13, 2016: Phlebology
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
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
Witold Woźniak, R Krzysztof Mlosek, Piotr Ciostek
INTRODUCTION: Thermal ablation techniques have gradually replaced Babcock procedure in varicose vein treatment. AIM: A comparative quantitative-qualitative analysis of complications and failure of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in a 5-year follow-up. MATERIALS AND METHODS: One hundred ten adult participants with varicose veins clinical grade C2 to C6, treated for isolated great saphenous vein (GSV) or small saphenous vein (SSV) insufficiency in a single lower extremity in 2009 to 2010, were enrolled and subdivided into EVLA (n = 56) and RFA (n = 54) groups...
October 2016: Vascular and Endovascular 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
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
Ali İhsan Tekin, Osman Nuri Tuncer, Mehmet Erdem Mehmetoğlu, Ümit Arslan, Ahmet Öztekin, Bayram Yağmur, Mahmut Biçer, Rıfat Özmen
METHODS: This is a single center prospective study of treatment of great saphenous vein incompatence in 62 patients with vein sealing system (Biolas VariClose(®) FG Group TURKEY) All cases were implemented under local anesthesia.Tumescent anesthesia was not required. Patients were not given any non-steroidal anti-inflammatory drug postoperatively only adviced to wear elastic bandages for one day and compression stockings was not offered. RESULTS: Treatment success was defined as complate occlussion of treated vein or recanalized segment shorter than 5 cm...
July 12, 2016: Annals of Vascular Surgery
Lowell S Kabnick, Mikel Sadek
OBJECTIVE: To define the relative importance of fiber type as compared to laser wavelength on tissue injury depth, postoperative pain, and bruising during endovenous laser ablation. METHODS: This study included 213 limbs that were treated with an 810-, 980-, or 1470-nm laser, with bare-tip (BT) or jacket-tip (JT) fibers. Pain scores (10-point scale) and bruising scores (5-point scale) were recorded. Tissue thermal injury depth (mm) was evaluated in vitro for the 810- and 1470-nm wavelengths with BT and JT fibers...
July 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Tom Wallace, Clement Leung, Sandip Nandhra, Nehemiah Samuel, Daniel Carradice, Ian Chetter
OBJECTIVES: To produce a tumescent anaesthesia solution with physiological pH for endovenous thermal ablation and evaluate its influence on peri- and postoperative pain, clinical and quality of life outcomes, and technical success. METHODS: Tumescent anaesthetic solution (0.1% lidocaine with 1:2,000,000 epinephrine) was titrated to physiological pH by buffering with 2 ml incremental aliquots of 8.4% sodium bicarbonate. Patients undergoing great saphenous vein endovenous laser ablation and ambulatory phlebectomy were studied before and after introduction of buffered tumescent anaesthetic...
June 15, 2016: Phlebology
Sanja Schuller-Petrovic
In the past 15 years, the minimally invasive endovenous treatments of varicose veins have been widely accepted. The efficacy of the different endovenous methods and the minimal post operative side effects are meanwhile well documented in a large number of evidence based publications. The recent NICE Guidelines (2013) considering the varicose vein treatment recommend in case of an insufficiency of saphenous veins first the endovenous thermal ablation with radiofrequency or laser, then the ultrasound guided sclerotherapy and as the third line the classic surgical treatment with stripping and high ligation...
June 2016: Wiener Medizinische Wochenschrift
M Cairols
No abstract text is available yet for this article.
August 2016: European Journal of Vascular and Endovascular Surgery
Tristan Lane, Roshan Bootun, Brahman Dharmarajah, Chung S Lim, Mojahid Najem, Sophie Renton, Kaji Sritharan, Alun H Davies
BACKGROUND: Endovenous thermal ablation has revolutionised varicose vein treatment. New non-thermal techniques such as mechanical occlusion chemically assisted endovenous ablation (MOCA) allow treatment of entire trunks with single anaesthetic injections. Previous non-randomised work has shown reduced pain post-operatively with MOCA. This study presents a multi-centre randomised controlled trial assessing the difference in pain during truncal ablation using MOCA and radiofrequency endovenous ablation (RFA) with six months' follow-up...
May 24, 2016: Phlebology
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
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
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
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
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
Mark H Meissner
Varicose veins affect one-quarter to one-third of Western adult populations and consume an increasing amount of health care resources. Much of this increased utilization has been driven by the advent of minimally invasive technology including endovenous thermal ablation, foam sclerotherapy, and more recently mechanicochemical and cyanoacrylate glue ablation. This has largely been driven by patient and physician preferences in the absence of robust evidence that one therapy is truly superior to another. This partially arises from misunderstandings about appropriate outcomes measures and what truly constitutes effective treatment of varicose veins...
March 2016: Phlebology
Xu-hong Wang, Xiao-ping Wang, Wen-juan Su, Yuan Yuan
Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation (EVLA) is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation (EMA). This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA (EMA group), and the rest 6 with EVLA (EVLA group)...
February 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
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