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

scholarly journals Clinical Correlation of Success and Complications of Lower Extremity Thermal Ablation

2015 ◽  
Vol 62 (3) ◽  
pp. 805
Author(s):  
Jesse Victory ◽  
Dmitriy Rybitskiy ◽  
Anjeza Zholanji ◽  
Enrico Ascher ◽  
Anil Hingorani
Keyword(s):  
Lower Extremity ◽  
Thermal Ablation ◽  
Clinical Correlation

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).

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

Clinical correlation of anatomical location of non-thrombotic iliac vein lesion

Vascular ◽  
2016 ◽  
Vol 25 (4) ◽  
pp. 359-363 ◽  
Author(s):  
Afsha Aurshina ◽  
Borislav Kheyson ◽  
Justin Eisenberg ◽  
Anil Hingorani ◽  
Arkady Ganelin ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Intravascular Ultrasound ◽  
Iliac Vein ◽  
Clinical Findings ◽  
Common Iliac Vein ◽  
Anatomical Location ◽  
Clinical Correlation ◽  
Common Site ◽  
External Iliac Vein ◽  
Left Lower Extremity

Objective Treatment of non-thrombotic iliac vein lesions is an active area of research. Intravascular ultrasound allows its localization. We chose intravascular ultrasound to clarify the exact anatomical location of non-thrombotic iliac vein lesions and correlate it with clinical findings. Materials and methods Over seven months, we performed ilio-femoral intravascular ultrasound studies on 217 patients, in 141 women and 76 men. The average age ± standard deviation was 68 ± 14 years. We used intravascular ultrasound intraoperatively to measure the ilio-femoral veins and compared it with adjacent non-stenotic ilio-femoral veins. If more than 50% area or diameter reduction was found, it was treated with appropriate balloon and stent. Results We identified 244 lesions, 124 in left lower extremity and 120 in the right lower extremity. The most common site was the proximal common iliac vein 38.7% (22.5% females and 16.12% males) in left lower extremity and middle external iliac vein 29.16% (18.33% females and 10.83% males) in right lower extremity. The least common site was the distal external iliac vein in 3.2% (all 3.2% females) and the distal external iliac vein 7.5% (5% females and 2.5% males) in right lower extremity. Clinical correlation was noted between laterality and location of the NIVL lesion ( p < 0.0001). Conclusion This analysis gives an insight into understanding the exact anatomical locations of the non-thrombotic iliac vein lesions helping clinicians and researchers guide their treatment and research.

A new factor of postoperative venous thrombosis in oncology: myth or reality?

2020 ◽  
Author(s):  
О.И. Кит ◽  
О.В. Кательницкая ◽  
И.И. Кательницкий ◽  
Н.С. Карнаухов ◽  
Е.В. Вереникина ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
High Rate ◽  
Oncological Patients ◽  
Single Centre Study ◽  
Endovenous Thermal Ablation ◽  
Thrombotic Complications ◽  
Morphologic Analysis ◽  
Anticoagulant Prophylaxis

Введение. Эндовенозная термическая абляция (ЭТА) поверхностных вен, включая лазерную абляцию или радиочастотную абляцию, широко применяется в лечении варикозной болезни нижних конечностей. Учитывая высокую частоту встречаемости варикозной болезни, частоту венозных тромбоэмболических осложнений (ВТЭО) после данного вмешательства, логично предположить, что выполнение ЭТА увеличит риск возникновения послеоперационного венозного тромбоза у онкологических больных. Существует недостаток данных о частоте ВТЭО в онкохирургии при ЭТА в анамнезе. Цель исследования: оценить влияние ранее проведенной ЭТА поверхностных вен нижних конечностей на послеоперационные ВТЭО в онкохирургии. Материалы и методы. Одноцентровое исследование с ретроспективным анализом онкологических больных на хирургическом этапе лечения злокачественных опухолей абдоминальной, гинекологической или урологической локализации проведено с мая 2013 г. по ноябрь 2018 г. В исследование были включены 36 пациентов, перенесших ЭТА более 3 мес назад (319 мес). Ультразвуковое дуплексное исследование вен нижних конечностей проводили перед операцией (за 110 дней) по поводу онкологического заболевания всем пациентам. Полная облитерация ствола большой подкожной вены (БПкВ) обнаружена в 66,7 случаев (n 24), реканализация в 33,3 (n 12). Все пациенты получали стандартную антикоагулянтную профилактику (надропарин по 0,4 мл/сут подкожно). Проведен морфологический анализ 3 случаев послеоперационного венозного тромбоза. Результаты. ВТЭО возникли в 20,8 (n 5) случаев при полной облитерации БПкВ, в 66,7 (n 8) с реканализацией ствола (95 ДИ 1,37,7) в послеоперационном периоде. Реканализация вены увеличила частоту развития послеоперационного венозного тромбоза в 3,2 раза. Заключение. ВТЭО часто возникают после неполной облитерации при ЭТА в отдаленном периоде при наличии дополнительных факторов риска. Учитывая широкое распространение данного типа операций во флебологии и возможность серьезных осложнений, необходимы дальнейшие исследования частоты венозного тромбоза при ЭТА в анамнезе у онкологических больных и определение стратегии профилактики ВТЭО. Introduction. Endovenous thermal ablation of saphenous vein (EVTA SV) including laser ablation or radiofrequency ablation widely used in varicose veins treatment of the lower extremities. EVTA SV can increase the risk of postoperative venous thrombosis in cancer patients. There is a deficiency of data examining rates of thrombotic events (VTE) in oncological patients. Aim: to assess influence of previously performed EVTA SV on postoperative VTE in oncosurgery. Materials and methods. This was a single centre study with retrospective analysis of consecutive oncological patients who underwent abdominal, gynecological or urological surgery from May 2013 to November 2018. 36 patients were included who underwent EVTA SV more than 3 month ago (319 months). Duplex ultrasound (DUS) was performed before oncological surgery (110 days). Complete SV obliteration was found in 66.7 of cases (n 24), recanalization in 33.3 (n 12). All patients had standard anticoagulant prophylaxis nadroparin 0.4 ml per day. We performed a morphologic analysis of 3 VTE cases. Results. Thrombotic complications occurred in 20.8 (n 5) of cases with complete SV obliteration, in 66.7 (n 8) with recanalization (95 CI 1.37.7). Recanalization of SV increased rate of postoperative cancer-associated VTE in 3.2 times. Conclusion. Thrombotic events occur frequently following incomplete obliteration after procedures EVTA SV. Taken account of the high rate of this procedures and the potential for serious consequences, further research is needed on VTE сomplications in oncology and their management.

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.

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