scholarly journals Comparative Study between Conventional Surgery and Radiofrequency Ablation in Treatment of Varicose Vein

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W A Elian ◽  
M I Mohamed ◽  
M Z Aborahma
Keyword(s):  
Radiofrequency Ablation ◽  
Recurrence Rate ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Normal Activity ◽  
Long Term Results ◽  
Conventional Surgery ◽  
Post Intervention ◽  
Major Complications ◽  
Duplex Imaging

Abstract Background Varicose veins are a very common problem all over the world. Surgery has been the gold standard treatment for many years, however now other less invasive options are available and sometimes more efficient. Aim of the Work to evaluate the RFA technique in treatment of GSV varicosities and to compare the results, clinical outcome, complications and recurrence rate after RFA and CS of GSV. Patients and Methods This observational retrospective study included 41 patients with varicose vein recruited from general surgery department and vascular surgery unit at Ain Shams Hospitals and in Nasser Institute for Research and Treatment. Results Operative time was significantly less in CS compared to RFA. One , six and twelve months post intervention follow up using clinical examination and duplex imaging were used to asses outcome and detect complications and recurrence rate. No major complications were detected after both techniques; however minor post operative complications like paresthesia and ecchymosis were significantly less after RFA. Post operative pain, duration of analgesia use and time needed to return to normal activity were also significantly less in RFA group than CS group. Recanalization of GSV was not detected after radiofrequency maneuver nor CS. This study proved that radiofrequency ablation technique is a safe and efficient in treating varicose veins however long-term results and cost effectiveness need further evaluation. Conclusion Conventional surgery has been used for a long time for treatment of varicose veins with variable degrees of minor to major complications. Duplex guided radiofrequency ablation is an efficient and a safe modality in the treatment of great saphenous vein varicosities. Of most importance is an adequate Duplex scan to identify accessory channels and double superficial systems.

scholarly journals Endovenous Laser Ablation and Radiofrequency Ablation versus Conventional Surgery in Treatment of Primary Varicose Vein of the Lower Limb)Prospective Randomized Controlled Study)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M Bahaaeldin ◽  
M A H Rady ◽  
A M E Dessouki ◽  
H I Abdelhamid
Keyword(s):  
Radiofrequency Ablation ◽  
Laser Ablation ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Current Evidence ◽  
Controlled Study ◽  
University Hospitals ◽  
Conventional Surgery ◽  
Endovenous Laser Ablation ◽  
Endovenous Ablation

Abstract Background Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) of primary varicose vein are thought to minimize postoperative morbidity and reduce work loss compared with the conventional surgical procedure. Aim of the Work to determine, whether endovenous ablation (radiofrequency and laser) have any advantages or disadvantages in comparison with conventional surgery, in the treatment of primary varicose vein. Patients and Methods this is a prospective randomized study. Thirty Patients presented at Vascular Outpatient Clinic for management of chronic venous insufficiency. All patients underwent clinical examination and duplex ultrasonography. Ten (10) patients were treated with ligation and stripping of the GSV or SSV. Ten (10) patients were treated with Radiofrequency ablation. Ten (10) patients were treated with endovenous laser ablation. The study was conducted at Ain Shams University Hospitals and Helwan University Hospitals. The study took place from September 2017 to June 2018. Results Compared with conventional surgery, endovenous ablation methods reduce postoperative discomfort and pain, with a lower complication rate after treatment for avoidance of a groin incision and dissection at the saphenofemoral confluence. Cosmetic demands are also better satisfied. However, risks of EVLA and RFA remain in terms of recanalization and neoreflux via junctional tributaries. Conclusion RFA and EVLA are minimally invasive procedures. Their potential early benefits, by avoiding groin dissection and GSV stripping, have been confirmed by the findings from this trial. Current evidence based on randomized trials consistently demonstrates significant early benefits after RFA and EVLA in suitable patients with varicose veins.

Recurrent varicose veins below the knee after varicose vein surgery

Phlebologie ◽  
2007 ◽  
Vol 36 (03) ◽  
pp. 132-136
Author(s):  
M. W. de Haan ◽  
J. C. J. M. Veraart ◽  
H. A. M. Neumann ◽  
P. A. F. A. van Neer
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Varicose Vein Surgery ◽  
Proximal Point ◽  
Perforating Veins ◽  
Recurrent Varicose Veins ◽  
Below The Knee ◽  
Duplex Imaging ◽  
Additional Value

SummaryThe objectives of this observational study were to investigate whether varicography has additional value to CFDI in clarifying the nature and source of recurrent varicose veins below the knee after varicose vein surgery and to investigate the possible role of incompetent perforating veins (IPV) in these recurrent varicose veins. Patients, material, methods: 24 limbs (21 patients) were included. All patients were assessed by a preoperative clinical examination and CFDI (colour flow duplex imaging). Re-evaluation (clinical and CFDI) was done two years after surgery and varicography was performed. Primary endpoint of the study was the varicographic pattern of these visible varicose veins. Secondary endpoint was the connection between these varicose veins and incompetent perforating veins. Results: In 18 limbs (75%) the varicose veins were part of a network, in six limbs (25%) the varicose vein appeared to be a solitary vein. In three limbs (12.5%) an incompetent sapheno-femoral junction was found on CFDI and on varicography in the same patients. In 10 limbs (41%) the varicose veins showed a connection with the persistent below knee GSV on varicography. In nine of these 10 limbs CFDI also showed reflux of this below knee GSV. In four limbs (16%) the varicose veins showed a connection with the small saphenous vein (SSV). In three limbs this reflux was dtected with CFDI after surgery. An IPV was found to be the proximal point of the varicose vein in six limbs (25%) and half of these IPV were detected with CFDI as well. Conclusion: Varicography has less value than CFDI in detecting the source of reflux in patients with recurrent varicose veins after surgery, except in a few cases where IPV are suspected to play a role and CFDI is unable to detect these IPV.

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

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.

Safe introduction of the VNUS Closure procedure: a multidisciplinary approach

2006 ◽  
Vol 21 (3) ◽  
pp. 122-126
Author(s):  
M S Mirza ◽  
J Madill ◽  
W Parsons ◽  
H Gajraj
Keyword(s):  
Multidisciplinary Approach ◽  
District Hospital ◽  
Clinical Excellence ◽  
Clinical Governance ◽  
Medical Director ◽  
Conventional Surgery ◽  
Intensive Training ◽  
Long Saphenous Vein ◽  
Major Complications ◽  
Duplex Imaging

Objectives: The National Institute for Health and Clinical Excellence supports the use of radiofrequency ablation (VNUS Closure) of the long saphenous vein (LSV) as an alternative to stripping. An increase in interest in the procedure is anticipated. The technique can produce serious complications not commonly associated with conventional surgery, and safety is a major concern with its introduction. The aim was to introduce the new technique into a district hospital, without major complications or failures. Methods: A multidisciplinary team was developed consisting of consultant surgeon, vascular technologist and theatre nurse, who received intensive training and mentoring from a group with considerable experience. All members attended operating theatre and duplex imaging sessions over a period of six months. Approval for the introduction of the technique into our institution was sought from the Medical Director and Clinical Governance Directorate. The results of VNUS Closure surgery were included in the monthly clinical governance and audit meetings. During the consent process, the first patient was informed that the team had not yet undertaken the procedure, but had taken all necessary measures to ensure its competence. Subsequently, patients were advised of our experience and the results. Results: Of the 18 patients who consented for the study, 13 (72%) were found on duplex scanning to have saphenofemoral reflux suitable for VNUS Closure. VNUS Closure was attempted in 22 LSVs in 13 patients; 21 LSVs (95%) in 12 patients were closed at surgery and 19 (86%) remained completely closed at a median of 12 months (range 3–24 months). There were no deaths and no major complications. Conclusion: The safe introduction of VNUS Closure in a district hospital can be accomplished through intensive training and a process of mentoring from experienced practitioners, a multidisciplinary approach with a vascular technologist in theatre and attention to governance issues, in particular audit and consent.

Varikose: Welche Komplikationen im Aufklärungsgespräch genannt werden sollten

2020 ◽  
Vol 8 (2) ◽  
pp. 60-61
Author(s):  
Markus Stücker
Keyword(s):  
Varicose Vein ◽  
Delphi Method ◽  
Thermal Injury ◽  
Varicose Veins ◽  
Cochrane Review ◽  
International Consensus ◽  
Major Complications ◽  
Consent Procedure ◽  
Intravenous Antibiotics ◽  
Ischemic Attack

Objective: To reach consensus on which complications of varicose vein treatments physicians consider major or minor, in order to standardize the informed consent procedure and improve shared decision-making. Methods: Using the e-Delphi method, expert physicians from 10 countries were asked to rate complications as «major» or «minor» on a 5-point Likert scale. Reference articles from a Cochrane review on varicose veins were used to compose the list of complications. Results: Participating experts reached consensus on 12 major complications: allergic reaction, cellulitis requiring intravenous antibiotics/intensive care, wound infection requiring debridement, hemorrhage requiring blood transfusion/surgical intervention, pulmonary embolism, skin necrosis requiring surgery, arteriovenous fistula requiring repair, deep venous thrombosis, lymphocele, thermal injury, transient ischemic attack/stroke, and permanent discoloration. Conclusion: An international consensus was reached about what physicians consider to be major complications of varicose vein treatments. This consensus may assist in standardizing the information physicians discuss with patients prior to varicose vein treatment.

scholarly journals Aldosterone-producing Adenoma in Primary Aldosteronism: CT-guided Radiofrequency Ablation—Long-term Results and Recurrence Rate

Radiology ◽  
2016 ◽  
Vol 281 (2) ◽  
pp. 625-634 ◽  
Author(s):  
Shirley Yuk Wah Liu ◽  
Charmant Cheuk Man Chu ◽  
Teresa Kam Chi Tsui ◽  
Simon Kin Hung Wong ◽  
Alice Pik Shan Kong ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Recurrence Rate ◽  
Primary Aldosteronism ◽  
Long Term Results ◽  
Ct Guided ◽  
Aldosterone Producing Adenoma

Treatment of varicose veins of lower limb: A prospective randomized comparison of radiofrequency ablation and conventional surgery

2014 ◽  
Vol 86 (6) ◽  
pp. 347-354
Author(s):  
Sunil Kumar Singh ◽  
Poras Chaudhary ◽  
Sachin Khandelwal ◽  
Devadatta Poddar ◽  
Upendra C. Biswal
Keyword(s):  
Radiofrequency Ablation ◽  
Lower Limb ◽  
Varicose Veins ◽  
Conventional Surgery

scholarly journals Radiofrequency ablation of varicose veins: experience at a tertiary hospital

2021 ◽  
Vol 15 (1) ◽  
pp. 37-40
Author(s):  
Farooq A Ganie ◽  
Ghulam Nabi Lone ◽  
Mohd Yaqoob Khan ◽  
Syed Mohsin Manzoor ◽  
Mudasir Hamid Bhat ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Varicose Vein ◽  
Great Saphenous Vein ◽  
Pulmonary Thromboembolism ◽  
Varicose Veins ◽  
Tertiary Hospital ◽  
Symptomatic Improvement ◽  
Seldinger Technique ◽  
One Year ◽  
Vein Disease

Background and objectives: Radiofrequency ablation (RFA) is a recent modality of treatment of the affected varicose vein. In the present study, the outcome of great saphenous varicose vein disease treated by radiofrequency ablation technique was analyzed. Methods: Patients with varicosities of the lower limb affecting mainly the great saphenous vein were (GSV) included. The procedures were carried out under spinal anesthesia. The target varicose vein was accessed by Seldinger technique and the RFA catheter advanced 2 to 3 cm below sapheno-femoral junction under ultrasonography (USG) guidance. A tumescent anesthetic infiltration was given in a solution of normal saline and sodium bicarbonate before the vein being ablated. Results: The success rate of RFA was 97.5 % (39 out of 40). One patient showed episodic recanalisation of vein at one year duplex colour scan. Though the complications related to procedure were negligible, one patient developed endovenous heat induced thrombosis (EHIT) and non-fatal pulmonary thromboembolism (PTE) which was managed adequately. Conclusion: Endovenous RFA is a useful treatment modality for varicose vein disease primarily due to great saphenous insufficiency with marked symptomatic improvement and least recurrence. Although the complications are minimal, EHIT is a potential and serious complication of heat ablation. Ibrahim Med. Coll. J. 2021; 15(1): 37-40

scholarly journals A One-Year Audit of Varicose Vein Surgery at a Vascular Surgical Unit with a Long-Term Duplex and Quality of Life Follow-Up

2021 ◽  
pp. 1-8
Author(s):  
Olle Nelzén ◽  
Olle Nelzén ◽  
Ingvor Fransson
Keyword(s):  
Quality Of Life ◽  
Varicose Vein ◽  
Open Surgery ◽  
Varicose Veins ◽  
Long Term Results ◽  
Primary Surgery ◽  
One Year

Objective: With the introduction of endovenous treatments, open varicose veins surgery was discarded due to a claimed high risk of neovascularisation. A one-year audit was set up to look at results from performing mainly open surgery. Methods: All varicose vein interventions were registered and prospectively followed with colour Duplex assessments after 4-6 weeks, 1 and >5 years. In addition, Aberdeen Varicose Vein Questionnaire (AVVQ) was used in addition to Varicose Vein Severity Score (VCSS) to assess patients’ quality of life (QoL) and the disease severity. Results: During the year, 236 patients/252 legs were operated and 28% were re-do procedures. Median age was 55 years (16-87) and 70% were females. Duplex at 4-6 weeks showed a primary success rate of 91%. Neovascularisation was noted in 8% one year after primary surgery. The long-term assessment was done after a median of 69 months (39-75) and 67% of all legs were examined. After primary surgery 16% showed neovascularisation compared with and 27% after re-do procedures. VCSS improved significantly from 6 (range 1-22) to 2 at the long-term follow-up (p<0.001). The AVVQ score improved from 20 (range 3-55) down to 10 (p<0.001). Conclusion: The risk for neovascularisation seems to have been overestimated and good long-term results can be achieved following modern open surgery. The major problem is to avoid varicose vein recurrence since results from re-do procedures seem less favourable long term.

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