scholarly journals Evaluation of a Physician Peer-Benchmarking Intervention for Practice Variability and Costs for Endovenous Thermal Ablation

2021 ◽  
Vol 4 (12) ◽  
pp. e2137515
Author(s):  
David P. Stonko ◽  
Chen Dun ◽  
Christi Walsh ◽  
Marlin Shul ◽  
John Blebea ◽  
...  
Keyword(s):  
Thermal Ablation ◽  
Endovenous Thermal Ablation ◽  
Practice Variability

American College of Phlebology Guidelines – Treatment of refluxing accessory saphenous veins

2016 ◽  
Vol 32 (7) ◽  
pp. 448-452 ◽  
Author(s):  
Kathleen Gibson ◽  
Neil Khilnani ◽  
Marlin Schul ◽  
Mark Meissner
Keyword(s):  
Systematic Review ◽  
Thermal Ablation ◽  
Clinical Impact ◽  
Review Of The Literature ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Saphenous Veins ◽  
Ablation Laser ◽  
Endovenous Thermal Ablation ◽  
Recommendation Grade

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).

Clinical correlation of success and acute thrombotic complications of lower extremity endovenous thermal ablation

2018 ◽  
Vol 6 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Afsha Aurshina ◽  
Enrico Ascher ◽  
Jesse Victory ◽  
Dmitriy Rybitskiy ◽  
Anjeza Zholanji ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Thermal Ablation ◽  
Clinical Correlation ◽  
Endovenous Thermal Ablation ◽  
Thrombotic Complications

Thromboembolic complications of endovenous thermal ablation and foam sclerotherapy in the treatment of great saphenous vein insufficiency

2014 ◽  
Vol 30 (5) ◽  
pp. 357-364 ◽  
Author(s):  
Meghan Dermody ◽  
Marlin W Schul ◽  
Thomas F O’Donnell
Keyword(s):  
Venous Thromboembolism ◽  
Randomized Controlled Trials ◽  
Thermal Ablation ◽  
Meta Analysis ◽  
Case Series ◽  
Controlled Trials ◽  
Foam Sclerotherapy ◽  
Bootstrap Analysis ◽  
Randomized Controlled ◽  
Endovenous Thermal Ablation

Objective Portions of these data were presented in a poster at the XVII World Meeting of the International Union of Phlebology, 8–13 September 2013, Boston, MA, USA. We assessed the incidence of venous thromboembolism following treatment of great saphenous insufficiency by endovenous thermal ablation or foam sclerotherapy using meta-analysis of published randomized controlled trials and case series. Methods Medline, Embase, Cochrane, and Clinical Trials Registry databases were searched from January 2000 through January 2013 for randomized controlled trials and large case series employing endovenous thermal ablation or foam sclerotherapy as a single modality for the treatment of great saphenous insufficiency, with concomitant postoperative duplex scanning. Pooled (stratified) incidence of venous thromboembolism with 95% confidence intervals was estimated using the DerSimonian–Laird procedure for random effects meta-analysis. A bootstrap analysis was performed to examine between-modality differences. Results Twelve randomized controlled trials and 19 case series investigating endovenous thermal ablation (radiofrequency ablation with VNUS/Covidien ClosureFAST™ catheter only, endovenous laser ablation, or both) were included. Data from 12 randomized controlled trials and 6 case series investigating nonproprietary foam preparations were analyzed. Estimated incidence of venous thromboembolism was low (mostly <1%) and similar across treatment modalities and study types. Conclusions Treatment of great saphenous insufficiency by endovenous thermal ablation or foam sclerotherapy is a common vascular intervention. The stratified incidence of venous thromboembolism appears to be low as reported in both randomized controlled trials and case series investigating these modalities. Although duplex scans were obtained postoperatively, a minority of studies specified protocols for venous thromboembolism detection.

Review of Endovenous Thermal Ablation of the Great Saphenous Vein

2018 ◽  
Vol 44 (5) ◽  
pp. 679-688 ◽  
Author(s):  
Omeed Ahadiat ◽  
Shauna Higgins ◽  
Alexandre Ly ◽  
Azadeh Nazemi ◽  
Ashley Wysong
Keyword(s):  
Saphenous Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Endovenous Thermal Ablation

Arteriovenous Fistula Is a Rare but Significant Finding After Endovenous Thermal Ablation

2019 ◽  
Vol 43 (3) ◽  
pp. 116-122
Author(s):  
Donna M. Kelly ◽  
Deborah Sanford ◽  
Julianne Stoughton
Keyword(s):  
Saphenous Vein ◽  
Thermal Ablation ◽  
Varicose Veins ◽  
English Literature ◽  
Significant Finding ◽  
Asymptomatic Patients ◽  
Vein Segment ◽  
Endovenous Thermal Ablation

Endovenous thermal ablation (EVTA) has become the mainstay of treatment for symptomatic varicose veins in the setting of saphenous vein insufficiency. We observed 5 iatrogenic arteriovenous fistulas (AVFs) following thermal ablation of the great saphenous vein (GSV). Postprocedure duplex ultrasound (DUS) results were analyzed for the presence of AVF in any location along or adjacent to the treated saphenous veins. Cases were prospectively followed. English literature was reviewed for any other published reports of AVF after EVTA. Data were compiled using our 5 cases, 2 cases were shared with us by colleagues and 20 cases were reported in the literature. Our center has performed more than 4000 (4155) cases of EVTA over the past 15 years. Five cases of AVFs were detected, 3 were found in asymptomatic patients during routine post-EVTA surveillance. The additional 2 cases presented with signs or symptoms which prompted a DUS after ablation. Including cases in the literature, we were able to identify 2 different types of AVFs. The first type of AVF was demonstrated in 13 cases where the AVF occurred along the treated vein. All of these cases involved ablation of the GSV and 90% of these showed signs of recanalization. The second type of AVF was seen in 14 additional cases where the AVF involved a vein segment adjacent to or remote from the ablated vein. The second type occurred in the GSV in 5 cases, external iliac vein (EIV) in 3 cases, and in the popliteal vein in 5 cases. There is 1 reported case of AVF involving the sural artery after perforator vein EVTA. Three of the type 1 cases were followed and spontaneously resolved; 3 of the type 1 cases were treated with surgical ligation with unreported outcomes. Seven cases did not report any follow-up information. Seven of the type 2 cases were treated, and had spontaneous resolution and 7 were not treated. The follow-up on these cases ranged from 1 month to 6 years. Thermal ablation can result in AVF either along the length of the treated vein or adjacent to the area of ablation. Further study would help elucidate the cause and treatment algorithms.

scholarly journals Randomized clinical trial of mechanochemical and endovenous thermal ablation of great saphenous varicose veins

2019 ◽  
Vol 106 (5) ◽  
pp. 548-554 ◽  
Author(s):  
S. Vähäaho ◽  
O. Mahmoud ◽  
K. Halmesmäki ◽  
A. Albäck ◽  
K. Noronen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Thermal Ablation ◽  
Varicose Veins ◽  
Endovenous Thermal Ablation

scholarly journals Endovenous Ablation of Varicose Veins Experience at Tertiary Neurological Center

2018 ◽  
Vol 1 (2) ◽  
pp. 94-96
Author(s):  
Sandeep Raj Pandey ◽  
George Bush Jung Katwal ◽  
Sharad Hari Gajuryal
Keyword(s):  
Saphenous Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Normal Activity ◽  
Vein Thrombosis ◽  
Long Term Follow Up ◽  
Endovenous Thermal Ablation

Introduction: Endovascular ablation of varicose vein either by radiofrequency ablationor laser delivers sufficient thermal energy to incompetent vein segments to produce irreversible occlusion, fibrosis and ultimately disappearance of the vein.Materials and Methods: Three hundred patients with varicosities due to primary or recurrent sapheno-femoral or sapheno-popliteal junction and great or small saphenous veinreflux underwent out-patient and in-patient endovenous thermal ablation between January 2015 to December 2017.The great saphenous vein was ablated from 2-2.5 cm below sapheno-femoral junction to knee and the small saphenous vein was ablated from mid-calf to the sapheno-popliteal junction.Results: Patient returning time to normal activity was 0–1 days returning to normal daily activity were immediately after 4 hours. Duplex ultrasound follow-up (median 3-months) confirmed abolition of sapheno-femoral junction/great saphenous vein and sapheno-popliteal junction/small saphenous vein reflux in all limbs. There were no instances of skin burns or deep vein thrombosis, but, 7 patients developed transient cutaneous numbness involving sural nerve and 1 developed endovenous heat induced thrombosis 3.Conclusions: This is likely to be more effective than conventional surgery, although long-term follow up is required.  Despite being expensive in comparison to open surgery, endovenous thermal ablation is superior in terms of: minimizing pain, avoiding incision, early mobilisation and discharge. Changing the treatment distance from 2 cm to 2.5 cm peripheral to the Deep veins junction may result in a diminished incidence of endovenous heat induced thrombosis 3.

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