Nerve Injury due to Endovenous Thermal Ablation for Varicose Veins

2018 ◽  
pp. 71-81
Author(s):  
Shoaib F. Padaria
Keyword(s):  
Nerve Injury ◽  
Thermal Ablation ◽  
Varicose Veins ◽  
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.

Successful lysis in a stroke following endovenous laser ablation and extensive miniphlebectomy of varicose veins

2015 ◽  
Vol 31 (4) ◽  
pp. 296-298 ◽  
Author(s):  
Luca Spinedi ◽  
Daniel Staub ◽  
Heiko Uthoff
Keyword(s):  
Ischemic Stroke ◽  
Laser Ablation ◽  
Thermal Ablation ◽  
Patent Foramen Ovale ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Foramen Ovale ◽  
Fatal Complication ◽  
Endovenous Laser Ablation ◽  
Endovenous Thermal Ablation

Stroke is a very rare but potential fatal complication of endovenous thermal treatment in patients with a right-to-left shunt. To our best knowledge, there are only two reports in the literature of stroke after endovenous thermal ablation of varicose veins, one after endovenous laser ablation and one after radiofrequency ablation and phlebectomy, both treated conservatively. This report describes a successful lysis in a patient with an ischemic stroke associated with bilateral endovenous heat-induced thrombosis class I after endovenous laser ablation of both great saphenous vein and extensive miniphlebectomy in a patient with an unknown patent foramen ovale.

scholarly journals Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins

2016 ◽  
Vol 18 (3) ◽  
pp. 58
Author(s):  
Sandeep Raj Pandey
Keyword(s):  
Clinical Outcome ◽  
Thermal Ablation ◽  
Open Surgery ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous System ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Same Day Discharge ◽  
Endovenous Thermal Ablation

Introduction and Objective: To compare open surgery, Endovenous thermal ablation(EVTA) and ultrasound(USG) guided foam sclerotherapy for primary superficial venous insufficiency(PVI) with respect to obliteration of superficial venous system at 3 months, clinical outcome and cost.Materials and Methods: Between January 2015 to January 2016, all patients with symptomatic PVI of lower limbs who were willing for definitive management were randomized to open surgery (n=20), EVTA (n=40) or ultrasound guided foam sclerotherapy (n=20). In foam sclerotherapy group, review USG was done at 1 week and if necessary re-injection was done. The patients in all the groups underwent review USG at 3 months. Obliteration of superficial venous system, clinical outcome and costs were registered.Results: 5 patients in foam sclerotherapy group required re-injection at 1 week. Superficial venous system was obliterated in all the patients of all the groups at 3 months. Improvement in clinical score was similar in all groups. The foam sclerotherapy group had less frequent analgesia intake, earlier return to normal activity and lower cost. Local complication rate was slightly higher in foam sclerotherapy group.Conclusion: Foam sclerotherapy is a cheaper alternative to open surgery & EVTA for PVI with respective to early measures of clinical outcome. USG guided sclerotherapy demonstrated to be a safe and effective procedure for the treatment of chronic venous insufficiency. The observed complications were minimal and most of the patients reported satisfaction with the treatment outcomes. If patient have no cost issue, endovenous thermal ablation of varicose veins is better than open surgery & foam sclera in context of minimally invasive, cosmetic, less pain, no incisions, early ambulation & same day discharge.

scholarly journals The Effectiveness of Endovenous Thermal Ablation for the Knee Symptoms of the Osteoarthritis with Varicose Veins

2021 ◽  
Author(s):  
Yuki Oga ◽  
Satoru Sugiyama ◽  
Susumu Matsubara ◽  
Yasuhiko Inaki ◽  
Masashi Matsunaga ◽  
...  
Keyword(s):  
Thermal Ablation ◽  
Varicose Veins ◽  
Endovenous Thermal Ablation

Guidelines of the First International Consensus Conference on Endovenous Thermal Ablation for Varicose Vein Disease – ETAV Consensus Meeting 2012

2014 ◽  
Vol 30 (4) ◽  
pp. 257-273 ◽  
Author(s):  
Miloš D Pavlović ◽  
Sanja Schuller-Petrović ◽  
Olivier Pichot ◽  
Eberhard Rabe ◽  
Uldis Maurins ◽  
...  
Keyword(s):  
Thermal Ablation ◽  
Task Force ◽  
Varicose Veins ◽  
Consensus Meeting ◽  
International Consensus ◽  
Vein Wall ◽  
Thermal Methods ◽  
Quality Of Evidence ◽  
Endovenous Thermal Ablation

Aim: Endovenous thermal ablation (ETA) procedures are catheter-directed, ultrasound (US)-guided thermal methods for treatment in varicose veins disease. Radiofrequency, laser or steam energy thermally denatures vein wall collagen, leading first to vein wall inflammation, then fibrosis and finally to occlusion. The aim of this guideline is to give evidence-based recommendations for ETA procedures. Methods: These guidelines were drafted during a consensus meeting of a group of experts in the field of ETA in June 2012 (Hvar, Croatia) under the auspices of the International Union of Phlebology (IUP). These guidelines review the present state of knowledge as reflected in peer-reviewed published medical literature. The recommendations of these guidelines are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines. Results: Recommendations on the use of ETA procedures were made based on the quality of evidence for efficacy, safety, tolerability, cosmetic outcome, patient satisfaction/preference and, where appropriate, on the experts' opinion. Health economics were not considered, since differences in national health systems and pricing make it difficult to form general conclusions that are relevant at an international level.

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