Search Results (7)

Background: Blood flow from the saphenofemoral junction(SFJ) tributaries may cause recurrence of varicose veins. Flush occlusion is defined as the total occlusion of the great saphenous vein(GSV) right to the saphenofemoral junction. The purpose of this study was to evaluate the efficacy and safety of flush endovenous thermal ablation with saphenofemoral junction tributary occlusion. Method: Between January 2019 and December 2022, 722 patients (total of 1273 limbs) were diagnosed with chronic vein insufficiency by one surgeon at a single center. Result: Of the 722 patients, 476 (65.9%) were female and 246 (34.1%) were male. Of the 1273 limbs, endovenous laser ablation(EVLA) was performed in 609 limbs and radiofrequency ablation(RFA) in 664 limbs. Of the 1273 limbs, the recurrence rate was 3.69% (n = 47), the development of endovenous heat-induced thromboembolism(EHIT) was 0.31% (n = 4), and neovascularization was 1.49% (n = 19). Conclusions: Flush endovenous thermal ablation was an effective method for decreasing recurrence without inducing endovenous heat-induced thromboembolism. Consecutive foam sclerotherapy for saphenofemoral junction tributaries may be feasible for reducing the recurrence of varicose veins. Full article

Objective: This study aimed to examine whether body weight may affect the effectiveness and safety of endovenous thermal ablation (ETA) for the treatment of symptomatic varicose veins. Methods: This retrospective single-center cohort study analyzed the outcomes and patient demographic data with a focus on the body weight of all patients who had ETA of symptomatic varicose veins between September 2017 and October 2020. Results: A total of 1178 treated truncal veins from 636 patients were analyzed. The mean ± standard deviation body mass index (BMI) was 25.5 ± 4.9. In 2.3% of cases, the patients were underweight (BMI < 18.5), 31.0% were overweight (BMI > 25), and 16.6% were obese (BMI > 30). Complete truncal occlusion was observed 1 year post intervention in 97.6–100% and patients were satisfied or very satisfied in 96.2–100% across BMI groups. Pain was low but significantly higher in the patients with obesity 6 weeks post intervention (visual analog scale 0.84 ± 1.49) and a higher infection rate was observed in the patients with obesity (n = 4/132; 3.0%). No significant association was observed between BMI and bleeding or thromboembolic events. Conclusions: Patients with obesity experienced prolonged pain and more infections after ETA, but ETA for varicose vein treatment remains effective and safe, independent of the patient’s BMI. Full article

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. Adverse events were collected. In the 55 study patients with 67 treated veins, the closure rate at 18 months was 94% (95% CI, 85–98%). Target vein diameter ≥9.5 mm had 81% sensitivity and 75% specificity for predicting recanalization. Quality-of-life scores improved significantly (p < 0.001 for both surveys). The only adverse event was a type IV allergic reaction to cyanoacrylate that was resolved with corticosteroid and histamine-antagonist therapy. Endovenous cyanoacrylate ablation was highly effective and is safe in experienced hands. Studies are warranted to determine whether changes in the protocol increase the closure rate in patients with target veins ≥9.5 mm in diameter. Full article

Background: A large amount of sclerosant is needed for the treatment of saphenous vein insufficiency with mechanochemical ablation (MOCA) for three or four veins with chronic venous insufficiency. In addition, what constitutes a safe amount is not clearly defined. In this study, we evaluate the feasibility of the combined endovenous laser and mechanochemical ablation to reduce the amount of sclerosant as compared with mechanochemical ablation monotherapy. Methods: A total of 327 patients diagnosed with superficial vein insufficiency between June 2018 and May 2020 and treated in a single center by one surgeon were evaluated retrospectively. There were 130 patients included who were treated with mechanochemical ablation (MOCA, Group I) and 197 patients who were treated with combined endovenous laser ablation and mechanochemical ablation (EVLA and MOCA, Group II). Results: The amount of sodium tetradecyl sulfate (STD) used per number of limbs was 5.5 ± 2.05 mL in Group I and 4.51 ± 1.2 mL in Group II (p < 0.001). The amount of STD used per number of veins was 4.77 ± 1.91 mL versus 3.12 ± 1.02 mL in Groups I and II, respectively, (p < 0.001). Recanalization rates within 52 weeks were 0% (0/130) in Group I and 5.58% (11/197) in Group II, while after 52 weeks they were 2.31% (3/130) in Group I and 6.60% (13/197) Group II and were not statistically significant. Complications within 4 weeks were 3.84% and 7.11% in Groups I and II, respectively. Conclusions: The results of this study show that combined EVLA and MOCA reduces the amount of sclerosant per the number of veins and legs treated as compared with MOCA monotherapy for three or four veins with chronic venous insufficiency. The combined EVLA and MOCA treatment in patients with three or four varicose veins has few side effects, reduces the amount of sclerotic agent, and can be considered to be an effective treatment method for inducing venous occlusion. Full article

Non-thermal endovenous ablations, due to the lowest probability of complications, are the new method of treating chronic venous insufficiency—one of the most common diseases globally. The Flebogrif system (Balton Sp. z o.o., Warsaw, Poland) is a new mechano-chemical ablation system causing the mechanical damage of endothelium that allows for better sclerosant penetration into its wall. The purpose of the article is to provide mechanical characteristics in the form of force–displacement dependence for a single cutting element, and a bundle of cutting elements of Flebogrif as a whole for different levels of protrusion of the bundle of cutting elements. A TA.HD plus (Stable Micro Systems, Godalming, UK) analyzer equipped with special handles, was used for characteristics testing. The head movement speed used was 5 mm·s⁻¹. The Flebogrif system was tested for three cutting element protrusion levels: L = L_max, L = 0.9·L_max, and L = 0.8·L_max. Before testing, geometric measurement of the spacing of the cutting elements for three proposed protrusions was performed. It was established that decreasing the working length of the cutting elements will increase their rigidity, and, as a result, increase the force exerted on the internal surface of the vein wall. The obtained characteristics will allow for specifying contact force variability ranges and the corresponding diameter ranges of operated veins. Full article

The aim of this study was to demonstrate the effects of compression following the endovenous laser ablation (EVLA) of incompetent great saphenous veins (GSVs) using a 1470 nm diode laser (Ceralas E 1470 nm, biolitec) and a 2ring radial fiber (ELVeS Radial 2ring™, biolitec). In this single-center prospective study, 150 legs of 150 consecutive patients were randomly allocated to one of three groups (A, B, and C). Group A patients did not undergo postoperative compression. Group B patients wore a thigh-length graduated compression stocking (23–32 mmHg) for 7 days, whereas group C patients wore the same stocking for 28 days. No additional phlebectomies or sclerotherapies were performed. Investigations were performed prior to intervention, at the day of intervention (D0), at day 7 (D7), and at day 28 post intervention (D28). The primary endpoint was post-interventional pain measured on a 10-point scale. A significant but small pain decrease was observed in the first week of compression, by comparing group B’s mean pain scores to those of group A (p = 0.009). Wearing a compression stocking after EVLA reduced pain within the first week on a significant, but low level. Taking the very low differences in pain levels into account, the difference may not be clinically relevant and post-treatment compression may not be necessary if no additional phlebectomies or sclerotherapies are performed. Full article

Background: The current treatment of venous disease is focused on the minimally invasive exclusion of the affected vein. Besides widely used thermal ablation, chemical ablation with cyanoacrylate, reported as safe and highly effective, has been gaining increasing interest. Patients and methods: In the current report, we present data from a two-year observation in 89 patients (61 female/28 male, mean age 44.3 ± 13.5) suffering from venous insufficiency (C2–C4), treated either using short-chain cyanoacrylate, the VenaBlock system (n = 43) or laser thermoablation with ELVeS 1470 (n = 46). The assessment comprised the occurrence of venous disease-related symptoms and the ultrasound examination of the leg venous system. Results: The frequency of recanalization after 2 years from the VenaBlock procedure was significantly higher than after laser treatment (37.2 vs. 8.7%). Apart from recanalization, in some individuals from both groups, the symptoms of recurrence and/or disease progression, including the development of insufficiency in other veins of treated or contralateral legs (9.3 vs. 15.2% and 9.3 vs. 17.4%, respectively), were observed. Unexpectedly, the general prevalence of the disease progression did not differ significantly between the VenaBlock and ELVeS groups (44.2 vs. 34.8%, respectively). Conclusions: Despite the higher recanalization rate of VenaBlock compared to ELVeS, the overall effectiveness of cyanoacrylate and laser thermoablation after two years was similar. Therefore, both methods similarly failed to prevent recurrence and disease progression, which seem to be method-independent. Full article