Prospective epidemiological study on the beginning of varicose veins

Summary Objective: To conduct a longitudinal vein study in a young study population on when and how varicose veins develop in healthy veins. Population, method: The initial study population consisting of pupils aged 10–12 (BO I, n = 740) underwent clinical and ultrasound follow-up at the ages of 14–16 (BO II, n = 518), 18–20 (BO III, n = 459) and 29–31 (BO IV, n = 136). During BO I-IV all venous findings detected (including preclinical refluxes of the saphenous veins) were recorded. Results: The data were broken down to reveal the incidence and prevalence of venous refluxes (VR), varicose veins (VV) and venous abnormalities (VA) for each part of the study. Furthermore, the data were analyzed longitudinally to identify any correlations between VR and VV in the two saphenous veins. Conclusions: Since none of the study subjects exhibited VV during BO I, the study permits evaluation of the venous situation in the subjects from birth on. The manifestation of a truncal VV is preceded by a VR in the same vein (p = 0.039). VR occurred mainly during puberty (BO I: 2.5%, BO III: 18.5%, BO IV: 25%). A preclinical VR represents a 30% risk (95% CI: 13–53%) of developing a truncal VV within four years, as a consequence, subsequent preventive 2-year follow-up examinations are recommended.

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Comparison of Short-Term Outcomes Between Endovenous 1,940-nm Laser Ablation and Radiofrequency Ablation for Incompetent Saphenous Veins

Frontiers in Surgery ◽

10.3389/fsurg.2020.620034 ◽

2020 ◽

Vol 7 ◽

Author(s):

Insoo Park ◽

Sun-Cheol Park

Keyword(s):

Radiofrequency Ablation ◽

Laser Ablation ◽

Varicose Veins ◽

Normal Activity ◽

Short Term ◽

Closure Rate ◽

Pain Scores ◽

Saphenous Veins ◽

Lower Pain

Background: Radiofrequency ablation (RFA) has shown faster recovery and lower pain scores compared to Endovenous laser ablation (EVLA) for treatment of varicose veins. However, a comparison of 1,940-nm EVLA and RFA has not been reported. This study compared short-term outcomes using 1,940-nm EVLA and RFA for varicose veins.Methods: Between April 2018 and June 2018, 43 patients (83 incompetent saphenous veins) were treated with 1,940-nm EVLA and 37 patients (64 incompetent saphenous veins) with RFA. Follow-up duplex was checked at 1 month and 3 months.Results: Baseline characteristics showed no significant differences between both groups except for age. Pain scores at 6 h, and at 1, 10, and 30 days after treatment showed no differences. Complications and time to return to normal activity showed no differences. The 100% closure rate was checked in both groups at 1 month and 3 months follow-up.Conclusion: Short-term outcomes showed no significant differences between 1,940-nm EVLA and RFA treatment.

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Recurrence patterns after endovenous laser treatment of saphenous vein reflux

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515596288 ◽

2016 ◽

Vol 31 (7) ◽

pp. 496-500 ◽

Cited By ~ 11

Author(s):

Ronald S Winokur ◽

Neil M Khilnani ◽

Robert J Min

Keyword(s):

Laser Ablation ◽

Varicose Veins ◽

Endovenous Laser Ablation ◽

Recurrent Varicose Veins ◽

Saphenous Veins ◽

Recurrence Patterns ◽

Endovenous Laser Treatment ◽

Saphenofemoral Junction ◽

Patterns Of Recurrence

Introduction The patterns of recurrent varicose veins after endovascular ablation of the saphenous veins are not well described. Methods The current study describes the ultrasound defined recurrence patterns seen in 58 patients (79 limbs) who returned for evaluation of recurrent varicose veins from a cohort of 802 patients treated with endovenous laser ablation and subsequent sclerotherapy from March 2000 to March 2007 with clinical follow-up until May 2014. Findings The most common ultrasound defined recurrence patterns leading to the varicose veins were new reflux in the anterior accessory saphenous and small saphenous veins as well as recanalization of the treated saphenous segment. Neovascularization at the saphenofemoral junction and incompetent perforating veins as the source of the recurrent veins were not seen. Conclusions The patterns of recurrence following thermal ablation of saphenous veins are different to those seen after surgery. Specifically, new reflux in other saphenous veins is responsible for most recurrent varicose veins and neovascularity seems to be unusual following endovenous laser ablation.

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Results of endovenous ClosureFast treatment for varicose veins in an outpatient setting

Phlebology The Journal of Venous Disease ◽

10.1258/phleb.2010.010089 ◽

2011 ◽

Vol 27 (3) ◽

pp. 118-123 ◽

Cited By ~ 21

Author(s):

U Bisang ◽

T O Meier ◽

M Enzler ◽

C Thalhammer ◽

M Husmann ◽

...

Keyword(s):

Complication Rate ◽

Varicose Veins ◽

Duplex Ultrasound ◽

Outpatient Setting ◽

Fast Recovery ◽

Patient’S Satisfaction ◽

Day Range ◽

Saphenous Veins

Objective Endovenous methods are increasingly used to treat varicose veins. We evaluated the outcome of patients treated with the new radiofrequency ablation (RFA)-ClosureFast catheter in an outpatient setting. Method Retrospective analysis of postinterventional duplex ultrasound (DUS), complication rate and quality of life of patients treated for incompetent saphenous veins. Results Between 2007 and 2009, 155 patients had been treated with ClosureFast. DUS was available from 73 (47%) patients (102 great [GSV] and 16 small [SSV] saphenous veins). After a mean follow-up of 12.2 months (range 1–29 months), DUS showed six (5.9%) open GSV and an occlusion of all treated SSV. One pulmonary embolism had occurred. Mean patient's satisfaction was 8.7 (10 = very satisfied), pain after one week 2.0 (no pain = 0, maximal = 10) and absence of work was 0.9 day (range 0–14 days). Conclusion RFA for incompetent saphenous veins can safely be performed in an outpatient setting with a low complication rate, minimal pain and fast recovery.

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Endovenous laser ablation of varicose veins with the 1470 nm diode laser using a radial fiber – 1-year follow-up

Phlebology The Journal of Venous Disease ◽

10.1177/0268355513512825 ◽

2013 ◽

Vol 30 (2) ◽

pp. 86-90 ◽

Cited By ~ 25

Author(s):

E von Hodenberg ◽

C Zerweck ◽

M Knittel ◽

T Zeller ◽

T Schwarz

Keyword(s):

Pulmonary Embolism ◽

Diode Laser ◽

Varicose Veins ◽

Endovenous Laser Ablation ◽

Vein Thrombosis ◽

Saphenous Veins ◽

Superficial Vein Thrombosis ◽

Radial Fiber ◽

Deep Vein

Background: Endovenous laser ablation is one of the most accepted treatment options for insufficient great and small saphenous veins. The aim of this study was to investigate the long-term efficacy and safety of the radial fiber (ELVeS-radial kit™) for the 1470 nm diode laser in a 1-year follow-up. Methods: A total of 308 lower limbs with primary insufficiency of great and small saphenous veins or insufficient tributaries were included in the prospective observational cohort study. The primary efficacy endpoint of the study was ultrasonographic proven elimination of venous reflux after at least 1 year. Secondary efficacy and further safety end points after 1 year were as follows: (1) sonographic exclusion of recanalization of the treated vein segments, (2) deep vein thrombosis, clinical pulmonary embolism or superficial vein thrombosis as defined by objective testing, (3) death from any cause, (4) persistent clinical complaints such as pain and paresthesia, (5) recurrent varicose veins. Patient satisfaction was assessed using a CIVIQ-2 questionnaire after 1 year. Results: Follow-up could be completed in 91.2% of the patients. Excellent efficacy numbers with 99.6% occlusion of the treated varicose veins as elimination of reflux could be demonstrated. After 1 year, 96% of the treated veins disappeared completely sonographically; one recanalization was observed. No deep vein thrombosis or pulmonary embolism occurred, three superficial vein thrombosis were diagnosed in follow-up examinations. Four patients died, not related to pulmonary embolism. No persistent pain or paresthesia occurred in the follow-up. Recurrent varicose veins were diagnosed in 10 patients (2.81%). Conclusion: One-year follow-up showed that endovenous laser treatment of varicose veins with 1470 nm diode laser using the radial fiber is highly effective, also regarding in a 1-year follow-up.

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First results with a new 1470-nm diode laser for endovenous ablation of incompetent saphenous veins

Phlebology The Journal of Venous Disease ◽

10.1258/phleb.2008.008038 ◽

2009 ◽

Vol 24 (1) ◽

pp. 26-30 ◽

Cited By ~ 104

Author(s):

F Pannier ◽

E Rabe ◽

U Maurins

Keyword(s):

Diode Laser ◽

Varicose Veins ◽

Vein Thrombosis ◽

Saphenous Veins ◽

Vein Segment ◽

First Results ◽

Laser Systems ◽

Occlusion Rate ◽

One Year

Introduction Most of the published EVLA data concern 810, 940, 980 nm diode lasers and 1064 or 1320 nm Nd:Yag laser systems. Major side effects are postoperative pain and bruising. The aim of this study was to show the outcome one year after EVLA of incompetent saphenous veins with a 1470 nm Diode laser (Ceralas E, biolitec). Patients and method Between December 2006 and February 2007, 134 saphenous veins (108 GSV, 26 SSV) in 117 legs of 100 consecutive patients where treated by EVLA for GSV and SSV incompetence. All patients were examined clinically and with duplex by an experienced phlebologist prior to intervention, and at the follow-up visits for complications, occlusion, flow and reflux in the treated vein segment. The clinical evaluation included clinical CEAP and the presence of recurrent varicose veins. Patient satisfaction was assessed by a 0 to 4 scale. Results After a mean follow-up period of 184 days (SD 27) 127 treated veins (102 GSV, 25 SSV) of 111 limbs in 94 patients and after 329 days (SD 14) 105 treated veins (94 GSV, 21 SSV) of 105 limbs in 83 patients were reinvestigated. Six patients were lost to follow up after six months and an additional 11 patients after one year. Up to one year follow-up all treated veins remained occluded. At six months, one new insufficient anterior accessory saphenous vein (AASV) and after 12 months, three new insufficient AASV occurred. After one year 45 patients were very satisfied with the method, 34 were satisfied, three were fairly and one was not satisfied. The mean of all answers was 0.5 (SD 0.5). In three cases phlebitic reactions after 10 days, but no severe complications such as deep vein thrombosis occured. After six months in 9.5% of the legs paresthesia was present in the treated area which reduced to 7.6% after one year. Intake of painkillers was mean 6.7 tablets (SD 3.5). When we compared GSV legs treated with LEED below or above 100 J/cm, the paresthesia rate was significantly lower in the first group with 2.3% compared to 15.5 % in the higher LEED group. The differences for number of days with analgesic intake and for the paraesthetic area were significant. Discussion In this prospective follow-up study with 100 consecutive patients and 134 treated saphenous veins a high occlusion rate of 100% could be demonstrated one year after treatment. However, with LEED > 100 J/cm in this study, the incidence of paresthesia rose significantly. Therefore it seems adequate to stay below 100 J/cm in the future as the occlusion rate was the same below and above 100 J/cm. Conclusion EVLA of GSV and SSV with a 1470 nm diode laser is a minimally invasive, safe and efficient therapy option with a high success rate.

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A multi-institutional review of endovenous thermal ablation of the saphenous vein finds male sex and use of anticoagulation are predictors of long-term failure

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520972923 ◽

2020 ◽

pp. 026835552097292

Author(s):

Young Erben ◽

Isabel Vasquez ◽

Yupeng Li ◽

Peter Gloviczki ◽

Manju Kalra ◽

...

Keyword(s):

Saphenous Vein ◽

Cox Regression ◽

Varicose Veins ◽

Closure Rate ◽

Cox Regression Analysis ◽

Saphenous Veins ◽

Occlusion Rate ◽

Male Sex

Background To review long-term outcomes and saphenous vein (SV) occlusion rate after endovenous ablation (EVA) for symptomatic varicose veins. Methods A review of our EVA database (1998–2018) with at least 3-years of clinical and sonographic follow-up. The primary end point was SV closure rate. Results 542 limbs were evaluated. 358 limbs had radiofrequency and 323 limbs had laser ablations; 542 great saphenous veins (GSV), 106 small saphenous veins (SSV) and 33 anterior accessory saphenous veins (AASV) were treated. Follow-up was 5.6 ± 2.3 years; 508 (74.6%) veins were occluded, 53 (7.8%) partially occluded and 120 (17.6%) were patent. On multivariable Cox regression analysis, male sex (HR 1.6, 95% CI [0.46–018], p = 0.012) and use anticoagulation (HR 2.0, 95% CI [0.69–0.34], p = 0.044) were predictors of long-term failure. On Kaplan-Meier curve, we had an 86.3% occlusion rate. Conclusion Our experience revealed a 5-year closure rate of 86.3%. Ablations have satisfactory occlusion rate.

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SARS-CoV-2 transmissions in students and teachers: seroprevalence follow-up study in a German secondary school in November and December 2020

BMJ Paediatrics Open ◽

10.1136/bmjpo-2021-001036 ◽

2021 ◽

Vol 5 (1) ◽

pp. e001036

Author(s):

Jakob Peter Armann ◽

Carolin Kirsten ◽

Lukas Galow ◽

Elisabeth Kahre ◽

Luise Haag ◽

...

Keyword(s):

Secondary School ◽

Initial Study ◽

Educational Settings ◽

Igg Antibody ◽

Registration Number ◽

Study Population ◽

Serial Blood Sampling ◽

Low Prevalence ◽

Second Wave

ObjectiveTo quantify the number of undetected SARS-CoV-2 infections in educational settings.DesignSerial SARS-CoV-2 seroprevalence study before and during the second wave of the COVID-19 pandemic.SettingSecondary school in Dresden, Germany.ParticipantsGrade 8–12 students and their teachers were invited to participate in serial blood sampling and SARS-CoV-2 IgG antibody assessment.Main outcome measureSeroprevalence of SARS-CoV-2 antibodies in study population.Results247 students and 55 teachers participated in the initial study visit and 197 students and 40 teachers completed follow-up. Seroprevalence increased from 1.7% (0.3–3.3) to 6.8% (3.8–10.1) during the study period mirroring the increase of officially reported SARS-CoV-2 infections during this time. The ratio of undetected to detected SARS-CoV-2 infections ranged from 0.25 to 0.33.ConclusionsWe could not find evidence of relevant silent, asymptomatic spread of SARS-CoV-2 in schools neither in a low prevalence setting nor during the second wave of the pandemic, making it unlikely that educational settings play a crucial role in driving the SARS-CoV-2 pandemic.Trial registration numberDRKS00022455.

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Endovenous laser ablation of great saphenous veins using a 1470 nm diode laser and the radial fibre – follow-up after six months

Phlebology The Journal of Venous Disease ◽

10.1258/phleb.2010.009096 ◽

2010 ◽

Vol 26 (1) ◽

pp. 35-39 ◽

Cited By ~ 65

Author(s):

F Pannier ◽

E Rabe ◽

J Rits ◽

A Kadiss ◽

U Maurins

Keyword(s):

Laser Ablation ◽

Diode Laser ◽

Laser Energy ◽

Varicose Veins ◽

Compression Stockings ◽

Efficient Treatment ◽

Endovenous Laser Ablation ◽

Saphenous Veins ◽

Bare Fibre

Background Endovenous laser ablation (EVLA) is an efficient method to treat insufficient great saphenous veins (GSV) with high occlusion rates.1–5 Most studies used 810, 940 or 980 nm diode lasers and a bare fibre.1,2,6 Moderate postoperative pain and bruising are frequent findings.2,6 Laser systems with higher wavelengths like 1470 nm with a higher absorption in water show less pain and bruising after the procedure.7–9 A newly-developed fibre (radial fibre, Biolitec) emits the laser energy radially around the tip directly into the venous wall contrary to the bare fibre.9 The aim of this study was to demonstrate the outcome and side-effects after EVLA of GSV with a 1470 nm diode laser (Ceralas E, Biolitec) by using the radial fibre. Methods Non-randomized, prospective study including 50 unselected limbs of 50 patients with a duplex sonographically verified incompetent GSV. EVLA was performed with a 1470 nm diode laser (Ceralas E, Biolitec) and a radial fibre. In the same session all insufficient tributaries were treated by phlebectomy. Tumescent local anaesthesia with 0.05% lidocaine was applied perivenously. Laser treatment was carried out in a continuous mode with a power of 15 W. Compression stockings (30 mmHg) were applied for one month. Postinterventional checkups took place one, 10, 30 days and six months after the procedure. Results Three patients were lost to follow-up. The average linear endovenous energy density (LEED) was 90.8 J/cm vein (SD 35.3). At the six month follow-up all treated veins remained occluded and no new reflux in the treated segments occurred. No recurrent varicose veins had occurred so far. No severe complications such as deep venous thrombosis could be detected. In four patients at 30 days and three patients at six months local paresthesia occurred in the region of EVLA. Forty-four percent of patients did not have any pain after the treatment and 50% did not take any analgesic tablets at any time after the procedure. Postoperative ecchymoses in the track of the treated GSV was rare. In 80% of the limbs, no ecchymoses was observed after the treatment. Conclusion EVLA of GSV with a radially emitting laser fibre by using a 1470 nm diode laser is a safe and efficient treatment option.

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100 Months Experiences With VenaSeal® Vein Glue: Long Time Follow - Up Study Conducted On 2912 Truncal Saphenous Veins In 1509 Cases

Angiology & Vascular Surgery ◽

10.24966/avs-7397/100054 ◽

2020 ◽

Vol 5 (3) ◽

pp. 1-7

Author(s):

Ulf Th Zierau ◽

Keyword(s):

Varicose Veins ◽

Quality Criteria ◽

Advantages And Disadvantages ◽

Treatment Techniques ◽

Saphenous Veins ◽

Long Time ◽

Prospective Comparative Study ◽

Therapy Quality ◽

Endovenous Treatment

The paper is about long - time experiences in treatment of truncal varicose veins with the vein glue VenaSeal®: 100 months - follow up of 1509 cases and 2912 truncal varicose veins. Since 1999 years by now, varicosis has been increasingly treated endovenously. At the start, the rather inconvenient VNUS® Closure plus - procedure and the more convenient linear laser procedure were used, and these were followed in 2007 by the bipolar RFITT® catheter, the VNUS® Closure Fast system and the radial laser. These endovenous treatment techniques were followed by the Clarivein System and the VenaSeal® System in 2011/2012. Thus, in the course of the last few years, plenty of experience has been gathered with endoluminal therapy, quality criteria have been defined and standards for the different techniques have been developed. The presented actual paper sheds light on the advantages and disadvantages of the vein glue VenaSeal® and presents the 100-months results of a single-center praxis study with prospective design. We will report about our experiences and results of a prospective comparative study of VenaSeal® - Closure in the treatment of 2512 saphenous veins (1949 GSV, 731 SSV, VSAL in 110 cases, VSAM in 87cases, femoropopliteal vein in 33 cases and Giacomini’s vein in 2 cases). Also ulcera crures were included in 17 cases (Figure 1).

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Impediment Profiling for Smoking Cessation: Results of a Pilot Study

American Journal of Health Promotion ◽

10.4278/0890-1171-17.5.300 ◽

2003 ◽

Vol 17 (5) ◽

pp. 300-303 ◽

Cited By ~ 6

Author(s):

Meghan O'Connell ◽

Sean C. Lucan ◽

Ming-Chin Yeh ◽

Elaine Rodriguez ◽

Dipti Shah ◽

...

Keyword(s):

Smoking Cessation ◽

Initial Study ◽

Control Group ◽

Concurrent Control ◽

Quit Rate ◽

Long Term Follow Up ◽

Study Population ◽

Survey Instruments

Objective. To test the effectiveness of a smoking cessation program based on “impediment profiling,” the elucidation of an individual participant's personal barriers, with provision of tailored interventions accordingly. Methods. A literature search was conducted to identify established impediments to smoking cessation. A long impediment profiler (LIP) was developed from validated survey instruments and used as a screening tool to identify individuals' barriers to quitting. Once barriers were identified, participants were assigned to up to seven interventions. Self-reported smoking cessation was confirmed with measurements of carbon monoxide concentrations in expired air of ≤10 ppm. Results. Nineteen adults participated in the pilot program. At the year 1 mark, 63.2% of the study population was smoke-free. The mean number of impediments of the study population was 3.5 ± 1.5. There was a negative association between subjects' quit status and the following impediments: stress (p = .0061), anxiety (p = .0445), and depression (p < .001). No single impediment was predictive of quit status. Conclusions. Impediment profiling as a basis for tailored smoking cessation intervention is associated with a high quit rate in this initial study, and it appears promising. Long-term follow-up is warranted, as is replication in a larger cohort with a concurrent control group.

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