Pretreatment elevated D-dimer levels without systemic inflammatory response are associated with thrombotic complications of thermal ablation of the great saphenous vein

2013 ◽  
Vol 1 (2) ◽  
pp. 154-158 ◽  
Author(s):  
Fedor Lurie ◽  
Robert L. Kistner
Keyword(s):  
Inflammatory Response ◽  
Saphenous Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Systemic Inflammatory Response ◽  
Thrombotic Complications ◽  
D Dimer

Haemostatic activation and Inflammatory response after three methods of treatment of great saphenous vein incompetence

2013 ◽  
Vol 29 (3) ◽  
pp. 154-163 ◽  
Author(s):  
L Dzieciuchowicz ◽  
G Espinosa ◽  
J A Páramo
Keyword(s):  
Inflammatory Response ◽  
Plasminogen Activator ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Statistical Significance ◽  
Plasminogen Activator Inhibitor ◽  
High Ligation ◽  
Methods Of Treatment ◽  
Pai 1 ◽  
D Dimer

Objective: The purpose of this study was to compare the activation of haemostasis and inflammatory response after three different methods of treatment of great saphenous vein (GSV) incompetence. Material and methods: Forty-five patients with GSV incompetence were assigned to one of the three types of treatment: high ligation and stripping (HL&S), radiofrequency ablation with ClosureFast (RFA) and endovenous laser ablation (EVLA) with 810 nm diode laser with miniphlebectomy if required. Peripheral blood samples were obtained in the morning before the surgery and 24 hours and 10 days after the procedure. The concentrations of C-reactive protein (CRP), D-dimer, prothrombin fragment 1+2 (F1 + 2), antigen of tissue plasminogen activator (t-PA) and von Willebrand factor (vWF) antigen and activity of plasminogen activator inhibitor (PAI-1) were determined. The results were statistically analysed with SPSS for Windows 15.0. Results: Thirty-eight patients completed the study: 13 from RFA, 14 from EVLA and 11 from HL&S group. The baseline data did not differ among groups. There was a significant increase of D-dimer in HL&S group after 24 hours ( P = 0.002). The changes in RFA and EVLA groups did not show statistical significance ( P = 0.092). PAI-1 decreased in RFA patients after 24 hours ( P = 0.02), did not change in EVLA patients, and tended to increase after HL&S (P = 0.08). The highest CRP increase was observed in HL&S group ( P = 0.003). No significant changes in F1 + 2, t-PA and vWF were observed in any group of patients at 24 hours. At 10 days, a further significant increase of D-dimer ( P = 0.04) and CRP ( P = 0.018) concentrations in HL&S but not RFA and EVLA patients was observed. Conclusions: Endovenous thermal ablation is associated with significantly less activation of haemostasis and inflammatory response when compared with HL&S.

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

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.

Endoluminal thermal ablation of the great saphenous vein (GSV) insufficiency

Phlebologie ◽  
2016 ◽  
Vol 45 (06) ◽  
pp. 357-362 ◽  
Author(s):  
C. Zollmann ◽  
P. Zollmann ◽  
J. Veltman ◽  
A. Gräser ◽  
I. Berger ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Laser Ablation ◽  
Prospective Study ◽  
Saphenous Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Treatment Technique ◽  
Ultrasound Guided ◽  
Previously Treated

SummaryTo evaluate and compare the fiveyear outcome after treatment of a varicose GSV by endovenous thermal laser ablation (EVLA) and radiofrequency ablation (RFA).In this non-randomized, prospective study, patients treated in 2007 and 2008 for complete varicosis of the GSV (CEAP: C2–C6) were divided according to the treatment technique used into three groups: RFA (VNUS ClosureFast™), EVLA 980 nm (ELVeS 980™) and EVLA 1470 nm (ELVeS 1470™). Ultrasound-guided follow-up consultations were conducted 3 days, 3 months, 1 year and 5 years after treatment.589 patients with 643 GSVs (223 RFA, 185 EVLA 980, 235 EVLA 1470) were treated under tumescent local anaesthesia. No major complications occurred and minor complications were rare (4.7–12.2 %, p=0.135).66 % (RFA), 15 % (EVLA 980) and 32 % (EVLA 1470) of the patients were pain-free without post-operative analgesics. After 5 years, 86 % (RFA), 90 % (EVLA 980) and 93 % (EVLA 1470) of the veins were occluded (p=0.096). Ultrasound imaging revealed reflux in treated GSVs in 5–8 % of cases (p=0.73). A second ablation of the previously treated GSV was required in 5 % (RFA), 2 % (EVLA 980) and 2 % (EVLA 1470) of the patients (p=0.28).Endoluminal thermal ablation is an easy, safe and well tolerated method for the treatment of varicosis. Radiofrequency ablation is less painful than EVLA. RFA and EVLA 1470 are equally effective for vein closure.

scholarly journals Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: First clinical experience

2008 ◽  
Vol 47 (1) ◽  
pp. 151-156.e1 ◽  
Author(s):  
Thomas Michael Proebstle ◽  
Bernadette Vago ◽  
Jens Alm ◽  
Oliver Göckeritz ◽  
Christian Lebard ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Saphenous Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein

scholarly journals Factors Associated with Recurrence of Varicose Veins after Thermal Ablation: Results of The Recurrent Veins after Thermal Ablation Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
R. G. Bush ◽  
P. Bush ◽  
J. Flanagan ◽  
R. Fritz ◽  
T. Gueldner ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Time Frame ◽  
Factors Associated ◽  
Perforating Veins ◽  
Contributory Factors ◽  
Ablation Study

Background. The goal of this retrospective cohort study (REVATA) was to determine the site, source, and contributory factors of varicose vein recurrence after radiofrequency (RF) and laser ablation.Methods. Seven centers enrolled patients into the study over a 1-year period. All patients underwent previous thermal ablation of the great saphenous vein (GSV), small saphenous vein (SSV), or anterior accessory great saphenous vein (AAGSV). From a specific designed study tool, the etiology of recurrence was identified.Results. 2,380 patients were evaluated during this time frame. A total of 164 patients had varicose vein recurrence at a median of 3 years. GSV ablation was the initial treatment in 159 patients (RF: 33, laser: 126, 52 of these patients had either SSV or AAGSV ablation concurrently). Total or partial GSV recanalization occurred in 47 patients. New AAGSV reflux occurred in 40 patients, and new SSV reflux occurred in 24 patients. Perforator pathology was present in 64% of patients.Conclusion. Recurrence of varicose veins occurred at a median of 3 years after procedure. The four most important factors associated with recurrent veins included perforating veins, recanalized GSV, new AAGSV reflux, and new SSV reflux in decreasing frequency. Patients who underwent RF treatment had a statistically higher rate of recanalization than those treated with laser.

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