Long-Term Outcomes of Endovenous Laser Ablation, n-Butyl Cyanoacrylate and Radiofrequency Ablation in the Treatment of Chronic Venous Insufficiency

Author(s):  
Helin El Kilic ◽  
Nilüfer Bektas ◽  
Macit Bitargil ◽  
İbrahim Ahmet Balkaya ◽  
Tolga Demir ◽  
...  
2019 ◽  
Vol 86 (10) ◽  
pp. 33-37
Author(s):  
O. V. Sokolov

Objective. Analysis of results of radiofrequency laser ablation and crossectomy with stripping in patients, suffering varicose disease of the lower extremities veins in ectasias, sizing more than 14 mm in saphenofemoral and saphenopopliteal junctions. Materials and methods. Analysis of the treatment results was conducted for 66 patients, among whom there were 46 women. Average age of the patients have constituted 54.7 yrs. The patients were divided into three groups: the first - 22 patients, in whom crossectomy with stripping was accomplished, the second - 21 patients, in whom endovenous laser ablation was done, and the third - 23 patients, in whom radiofrequency ablation was performed. Level of the pain intensity was estimated during 7 days, dynamics of severity of chronic venous insufficiency, presence of complications and recurrences half a year postoperatively. Results. Severity of chronic venous insufficiency have reduced in 6 mo in all the groups under the influence of treatment: in the first group - by 63.8%, in second - by 50.1%, in the third - by 65.3%. The most reduction of the pain level (by 50%) on the second day postoperatively were registered in patients of the third group. Half a year before a recurrence in the first group have occurred in 4 (18.2%) patients, in the second - in 3 (14.3%), and in the third - in 1 (4.3%) patients. Conclusion. The selected methods of surgical treatment for varicose disease of the lower extremities are effective. In presence of ectasias of saphenofemoral and saphenopopliteal junctions the morbidity and recurrence rates were lowered, the pain indices reduced after the radiofrequency ablation application, comparing with endovenous laser ablation and crossectomy with stripping.


2016 ◽  
Vol 32 (6) ◽  
pp. 415-424 ◽  
Author(s):  
Malcolm Sydnor ◽  
John Mavropoulos ◽  
Natalia Slobodnik ◽  
Luke Wolfe ◽  
Brian Strife ◽  
...  

Purpose To compare the short- and long-term (>1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein. Materials and methods Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction. Clinical assessment of each patient was conducted at one year and then at yearly intervals for patient satisfaction. Results Post-procedure pain ( p < 0.0001) and objective post-procedure bruising ( p = 0.0114) were significantly lower in the radiofrequency ablation group. Improvements in venous clinical severity score were noted through six months in both groups (endovenous laser ablation 6.6 to 1; radiofrequency ablation 6.2 to 1) with no significant difference in venous clinical severity score ( p = 0.4066) or measured adverse effects; 89 endovenous laser ablation and 87 radiofrequency patients were interviewed at least 12 months out with a mean long-term follow-up of 44 and 42 months ( p = 0.1096), respectively. There were four treatment failures in each group, and every case was correctable with further treatment. Overall, there were no significant differences with regard to patient satisfaction between radiofrequency ablation and endovenous laser ablation ( p = 0.3009). There were no cases of deep venous thrombosis in either group at any time during this study. Conclusions Radiofrequency ablation and endovenous laser ablation are highly effective and safe from both anatomic and clinical standpoints over a multi-year period and neither modality achieved superiority over the other.


2019 ◽  
Vol 03 (02) ◽  
pp. 081-088
Author(s):  
Sushmita Shailendra Deshmukh ◽  
Pankaj Banode ◽  
Abhinav Mohan

Abstract Background Chronic venous insufficiency (CVI) manifests as unilateral or bilateral lower-limb venous hypertension causing pain, swelling, edema, and skin changes, among other symptoms. CVI affects patients’ socioeconomic status, is particularly seen in the young, and, in its severe manifestation, may have a debilitating effect on patients’ quality of life (QoL). The authors wanted to evaluate change in pain and QoL among rural patients after endovenous laser ablation (EVLA) treatment in a pilot study. Methods Twenty patients having CVI who opted for 1,470-nm EVLA treatment were enrolled at the Interventional Radiology department between July 2018 and September 2018. The authors evaluated pain using the visual analog scale (VAS) before and after EVLA procedure (standard protocol) of the affected vein. They also assessed QoL using the Aberdeen Varicose Vein Questionnaire before and 6 weeks after EVLA. Results The authors observed significant reduction in pain postprocedure versus preprocedure. Majority of the patients had improvement in itching and stasis dermatitis after the procedure. Rash and skin ulcers remained uncommon before and after EVLA. Also, after EVLA, fewer patients than before reported that the appearance of their diseased veins caused them concern (35 vs. 65% before EVLA), influenced their choice of clothing (45 vs. 80%), interfered with their work (40 vs. 90%), and interfered with their leisure activities (30 vs. 80%). Conclusion EVLA 1470nm procedure may help patients with CVI attain improved QoL and significant pain reduction.


2018 ◽  
Vol 105 (13) ◽  
pp. 1759-1767 ◽  
Author(s):  
T. Wallace ◽  
J. El-Sheikha ◽  
S. Nandhra ◽  
C. Leung ◽  
A. Mohamed ◽  
...  

Vascular ◽  
2016 ◽  
Vol 24 (6) ◽  
pp. 649-657 ◽  
Author(s):  
Renata Balint ◽  
Akos Farics ◽  
Krisztina Parti ◽  
Laszlo Vizsy ◽  
Jozsef Batorfi ◽  
...  

Objective The aim of this review article was to evaluate the long-term technical success rates of the known endovenous ablation procedures in the treatment of the incompetence of the great saphenous vein. Methods A literature search was conducted in the PubMed-database until the 5 January 2016. All publications with four to five years follow-up were eligible. Meta-analysis was performed by the IVhet-model. Results Eight hundred and sixty-two unique publications were found; 17 of them were appropriate for meta-analysis. Overall, 1420 limbs were included in the trial, 939 for endovenous laser ablation, 353 for radiofrequency ablation and 128 for ultrasound guided foam sclerotherapy. Overall, technical success rates were 84.8% for endovenous laser ablation, 88.7% for radiofrequency ablation and 32.8% for ultrasound guided foam sclerotherapy. There were no significant differences between endovenous laser ablation, radiofrequency ablation and ultrasound guided foam sclerotherapy regarding the great saphenous vein reopening ( p = 0.66; OR: 0.22; 95% of CI: 0.08–0.62 for radiofrequency ablation vs. endovenous laser ablation; p = 0.96; OR: 0.11; 95% of CI: 0.06–0.20 for endovenous laser ablation vs. ultrasound guided foam sclerotherapy; p = 0.93; OR: 3.20; 95% of CI: 0.54–18.90 for ultrasound guided foam sclerotherapy vs. radiofrequency ablation). Conclusion Both endovenous laser ablation and radiofrequency ablation are efficient in great saphenous vein occlusion on the long term. Lacking long-conducted large trials, the efficacy and reliability of ultrasound guided foam sclerotherapy to treat great saphenous vein-reflux is not affirmed.


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