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endovenous thermal ablation

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https://www.readbyqxmd.com/read/28767808/preliminary-results-of-severe-venous-insufficiency-treatment-with-thermal-ablation-of-the-great-saphenous-vein-by-endovascular-technique-with-laser-diode-980nm-developed-in-brazil-associated-with-sclerotherapy-with-polidocanol
#1
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
https://www.readbyqxmd.com/read/28718606/-interventional-treatment-of-venous-insufficiency
#2
Barbara Ney, Rolf P Engelberger, Amin Dabiri, Jean-François Lüthi, Andreas Erdmann, Caroline Krieger, Sébastien Déglise, Thierry Merminod, Philippe Kern, Lucia Mazzolai
Interventional treatment of venous insufficiency has been revolutionized by endovascular techniques. Some of these techniques, and particularly thermal ablation (endovenous laser, radiofrequency) are now recommended as first-line therapy in the latest international guidelines. This is because of less post-operative pain, a shorter leave from employment and similar or lower recurrence rate. Endovenous techniques allow safer and more efficient treatment of certain particular conditions : small saphenous vein, ulcers, and recurrent varicose veins...
March 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28697961/fifteen-year-results-of-radiofrequency-ablation-using-vnus-closure-for-the-abolition-of-truncal-venous-reflux-in-patients-with-varicose-veins
#3
M S Whiteley, I Shiangoli, S J Dos Santos, E B Dabbs, T J Fernandez-Hart, J M Holdstock
OBJECTIVES: Endovenous thermal ablation (EVTA) of varicose veins was introduced in the late 1990s with radiofrequency ablation (RFA) using the VNUS Closure device. The results of the original VNUS Closure device for the abolition of truncal venous reflux at 15 years are reported. METHODS: A prospective audit of a group of patients treated with VNUS Closure 15 years previously was carried out, using clinical assessment and duplex ultrasound. A total of 189 patients were treated with VNUS Closure between March 1999 and December 2001 and were invited for clinical assessment (subjective and objective) and duplex ultrasonography (DUS) to assess treatment outcome and de novo disease progression...
July 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28623990/incidence-of-venous-leg-ulcer-healing-and-recurrence-after-treatment-with-endovenous-laser-ablation
#4
William A Marston, Jason Crowner, Ana Kouri, Corey A Kalbaugh
BACKGROUND: The Effect of Surgery and Compression on Healing and Recurrence (ESCHAR) trial previously reported that patients with venous leg ulcers treated with saphenous stripping experienced a significantly reduced incidence of ulcer recurrence compared with patients treated with compression therapy. Most patients with leg ulcers and saphenous insufficiency are currently treated with endovenous thermal ablation (EVTA), but little information is available on the long-term results after EVTA in Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) clinical class 5 (C5) and class 6 (C6) patients...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28485865/chronic-venous-insufficiency-a-review-of-pathophysiology-diagnosis-and-treatment
#5
Bettina Santler, Tobias Goerge
Chronic venous disease is a common disorder associated with a variety of symptoms in later disease stages but also with complications such as venous leg ulcer. This, in turn, has substantial socioeconomic effects and significantly impacts patients' quality of life. While there are a number of diagnostic procedures available, color-flow duplex ultrasound has become the gold standard. As regards therapeutic options, major advances have been made in recent decades. Today, there are alternatives to saphenofemoral ligation and stripping of the great saphenous vein, including endovenous thermal ablation techniques...
May 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28466194/the-role-of-laser-power-and-pullback-velocity-in-the-endovenous-laser-ablation-efficacy-an-experimental-study
#6
N Yu Ignatieva, O L Zakharkina, C V Masayshvili, S V Maximov, V N Bagratashvili, V V Lunin
Endovenous laser ablation is an effective and minimally invasive alternative to surgical removal of incompetent veins. However, many controversies concerning optimal laser parameters usage in this procedure still remain. The purpose of this experimental study was to assess the adequate parameters required for vein wall destruction and to evaluate the role of fiber pullback velocity on vessel wall degradation. Varicose vein segments were treated with 1470-nm diode laser 3 to 9.5 W in power. The fiber moved through the vein at a velocity of 0...
May 2, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28440727/foam-sclerotherapy-of-the-great-saphenous-vein-in-association-with-pre-terminal-saphenous-junction-ligation-division-as-an-office-based-procedure-12-month-results
#7
Moro Leo, Ricci Stefano, Antonelli Incalzi Raffaele
Objective Ultrasound-guided foam sclerotherapy (UGFS) - one of the most frequently recommended methods for treating great saphenous vein incompetence - is easy and inexpensive. However, it achieves a lower occlusion rate compared to endovenous thermal ablation. The application of UGFS to pre-terminal great saphenous vein interruption, eliminating the saphenous stem wash out effect, enhances the short-term occlusion rate. This study explores the results of this technique at 12 months. Method Thirty great saphenous veins (28 patients) with junction incompetence, with calibres >6 mm and >30 cm reflux stem length were submitted to echo-guided pre-terminal great saphenous vein interruption and foam great saphenous vein occlusion...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28409546/clinical-correlation-with-failure-of-endovenous-therapy-for-leg-swelling
#8
Ahmad Alsheekh, Anil Hingorani, Natalie Marks, Yuriy Ostrozhynskyy, Enrico Ascher
Background The development and use of minimally invasive procedures provide improved options for the management of symptoms of chronic venous insufficiency. While many patients with iliac venous occlusive disease and superficial venous insufficiency improve with combined iliac venous stenting and correction of superficial venous reflux, some patients have symptoms which persist. The goal of this study was to identify clinical factors related to persistent symptoms in patients with leg swelling after treatment of both iliac vein stenting and thermal ablation...
June 2017: Vascular
https://www.readbyqxmd.com/read/28376578/a-synopsis-of-current-international-guidelines-and-new-modalities-for-the-treatment-of-varicose-veins
#9
Nicholas Kemp
BACKGROUND: The UK National Institute for Health and Care Excellence released new guidelines in 2013 recommending that endovenous thermal ablation (laser or radiofrequency) and ultrasound-guided foam sclerotherapy should be offered before conventional surgery for treat-ment of varicose veins and saphenous vein reflux. OBJECTIVE: The aim of this article is to provide a synopsis of current international guidelines and recent advances for the treatment of varicose veins...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28238282/endovenous-ablation-of-refluxing-saphenous-and-perforating-veins
#10
REVIEW
Thomas Proebstle, Renate van den Bos
Since the end of the nineties endovenous thermal ablation and more recently non-thermal, non-tumescent techniques have been developed and improved. Until now, because of their favourable side effect profile in conjunction to sustained efficacy, in many countries they already replaced high ligation and stripping in the treatment of refluxing saphenous veins as well as for treatment of perforators and selected tributaries. Now, studies and comparative trials are available with long-term follow-ups for most of the techniques, providing valid data on occlusion and reflux rates, side effect profiles, and health related quality of life...
May 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28151029/radiofrequency-induced-thermotherapy-rfitt-in-a-porcine-liver-model-and-ex-vivo-great-saphenous-vein
#11
George E Badham, Scott J Dos Santos, Mark S Whiteley
AIMS: To investigate the thermal spread achieved in porcine liver when using an optimised radiofrequency ablation protocol and correlate findings with the effects seen in ex vivo great saphenous vein (GSV), in order to justify clinical use with the new treatment protocol. MATERIAL AND METHODS: Porcine liver and GSV sections were treated with radiofrequency-induced thermotherapy (RFiTT) using the following settings: 20 W at 1 s/cm (linear endovenous energy density; LEED 20 J/cm), 18 W at 1 s/cm (LEED 18 J/cm), 18 W at 3 s/cm (LEED 54 J/cm), 6 W interrupted pull-back 6 s stationary every 0...
August 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28063094/stasis-dermatitis-pathophysiology-evaluation-and-management
#12
REVIEW
Swaminathan Sundaresan, Michael R Migden, Sirunya Silapunt
Stasis dermatitis commonly occurs in older age. It is caused by venous hypertension resulting from retrograde flow due to incompetent venous valves, valve destruction, or obstruction of the venous system. Further tissue changes arise from an inflammatory process mediated by metalloproteinases, which are up-regulated by ferric ion from extravasated red blood cells. Stasis dermatitis presents initially as poorly demarcated erythematous plaques of the lower legs bilaterally, classically involving the medial malleolus...
June 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28018497/morphological-comparison-of-blood-vessels-that-were-heated-with-a-radiofrequency-device-or-a-1470-nm-laser-and-a-radial-2ring-fiber
#13
Takashi Yamamoto, Masahiro Sakata
Introduction: Radio waves and lasers can be used as heat sources during endovenous thermal ablation (EVTA) for saphenous vein insufficiency. A morphological comparison of veins that had been treated with EVTA was performed between those treated with an endovenous closure system (a radiofrequency [RF] system) and those treated with a Radial 2Ring fiber connected to a 1470-nm laser generator (2R). Methods: The experiment was conducted in a system that reproduces the physiological conditions found in the saphenous veins during EVTA...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/27981883/varicose-vein-therapy-and-nerve-lesions
#14
Tobias Hirsch
Treating varicose veins using endovenous thermal techniques - especially laser and radio frequency ablation - has emerged as an effective alternative to open surgery with stripping and high ligation. Even though these methods are very gentle and patient-friendly, they are nevertheless accompanied by risks and side effects. Compared to open surgical therapy, the risk of damage to peripheral and motor nerves is reduced; however, it still exists as a result of heat exposure and tumescent anaesthesia. Non-thermal methods that can be applied without tumescent anaesthesia have been introduced to the market...
March 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27898181/endovenous-ablation-therapy-laser-or-radiofrequency-or-foam-sclerotherapy-versus-conventional-surgical-repair-for-short-saphenous-varicose-veins
#15
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/27738242/american-college-of-phlebology-guidelines-treatment-of-refluxing-accessory-saphenous-veins
#16
REVIEW
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
https://www.readbyqxmd.com/read/27727418/-modern-management-of-varicose-veins
#17
REVIEW
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
#18
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/27681171/complications-and-failure-of-endovenous-laser-ablation-and-radiofrequency-ablation-procedures-in-patients-with-lower-extremity-varicose-veins-in-a-5-year-follow-up
#19
COMPARATIVE STUDY
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
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
#20
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
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