Is catheter-directed foam sclerotherapy more effective than the usual foam sclerotherapy for treatment of the great saphenous vein?

2018 ◽  
Vol 33 (9) ◽  
pp. 646-652 ◽  
Author(s):  
Orsini Camillo
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Statistical Significance ◽  
Long Term Results ◽  
Complication Rates ◽  
Foam Sclerotherapy ◽  
Occlusion Rate ◽  
Long Term Experience

Objective This retrospective study presents the long-term results of catheter-directed foam sclerotherapy of the great saphenous vein. Method From January 2003 to June 2017, 277 patients with varices and great saphenous vein incompetence were treated with echo-guided foam sclerotherapy. Forty-six patients were treated with long-catheters guided by foam sclerotherapy. Foaming was carried out with sodium-tetra-decyl-sulphate. Results Results were examined in the two groups: A (long-catheters) and B (other procedures). The median overall follow-up was 52.1 months. In the A-group, the complete occlusion rate was 34/46 pts (73.9%) and partial occlusion was 10/46 (21.7%). In the B-group, respectively, 130/231 (56.2%) and 90/231 (38.9%). Comparisons between groups were statistically significant (p = 0.023; p = 0.021). Failures involved, respectively, 2/46 (4.3%) and 11/231 (4.7%) with no statistical significance. The complication rates were similar in the two groups. Conclusions In this long-term experience (median follow-up exceeding four years), foam-guided sclerotherapy of the great saphenous vein with a long-catheter turned out to be more effective than the usual foam-guided sclerotherapy.

Five-year outcomes of mechano-chemical ablation of primary great saphenous vein incompetence

2019 ◽  
Vol 35 (4) ◽  
pp. 255-261
Author(s):  
Naomi DE Thierens ◽  
Suzanne Holewijn ◽  
Wynand HPM Vissers ◽  
Debbie AB Werson ◽  
Jean Paul PM de Vries ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
Long Term Results ◽  
Venous Clinical Severity Score ◽  
Ceap Classification ◽  
Chemical Ablation ◽  
Anatomical Success

Objective The aim of the study is to report long-term results after mechano-chemical ablation for the treatment of great saphenous vein incompetence. Methods Mechano-chemical ablation was performed using the ClariVein device with polidocanol as the sclerosant. Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) classification, Venous-Clinical-Severity-Score (VCSS), anatomical-success, RAND-SF36 and the Aberdeen-Varicose-Vein-Questionnaire (AVVQ) were obtained by clinical examination, questionnaires and duplex ultrasonography through five years’ follow-up (Clinicaltrials.gov, NCT01459263). Results Ninety-four patients (113 great saphenous veins) were included in the study. Five-year follow-up data were available for 75 limbs (66.4%). Freedom from anatomical failure was 78.7% (N = 45) with 64.6% (N = 42) having an improvement in the VCSS ≥1. A total of five reinterventions were performed through five years with a median time to reintervention of 38 months. The VCSS at five years was 2 (IQR 1; 4) and was still significantly improved compared to baseline (p < 0.001). A deterioration of the VCSS was observed in 21.5%. Conclusion Through five-year follow-up, there are a significant number of anatomical and clinical failures in this series, mainly driven by partial recanalizations.

Long-term results after radiofrequency ablation in 1998

Phlebologie ◽  
2014 ◽  
Vol 43 (04) ◽  
pp. 197-200
Author(s):  
A. Brunner ◽  
J. Noppeney ◽  
T. Noppeney
Keyword(s):  
Radiofrequency Ablation ◽  
Clinical Examination ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Lower Leg ◽  
Entire Length ◽  
Long Term Results ◽  
The Mean

Summary Introduction: In 1998, radiofrequency ablation (VNUS Closure Plus™) was authorised in Germany and Europe for the treatment of superficial reflux. We participated in a clinical registry set up by the manufacturing company in 1998. The aim of this retrospective paper was to analyse the long-term results after radiofrequency ablation. Materials, methods and patients: In 1998, we operated on twelve patients (8 women, 4 men). In accordance with the concept of standard vein stripping surgery, all endovenous ablations were combined with crossectomy or ligature of the saphenopopliteal junction. Each vein was thermally ablated over its entire length and no tumescent anaesthesia was performed. The mean age of the twelve patients was 44.9 years. On ten occasions, the entire length of the great saphenous vein was treated, on one occasion the great saphenous vein at the level of the lower leg and on one occasion the entire length of the small saphenous vein. The mean duration of surgery was 80 minutes. Results: The follow-up period was 3 to 168 months, with a mean duration of 80 months. Six patients were followed up for longer than 120 months. In eight cases, the follow-up examination was performed using duplex ultrasound, in two cases using clinical examination and non-invasive testing, in one case using clinical examination and in one case via a telephone interview.The most frequent perioperative complication, occurring in six cases, was hypaesthesia at the medial malleolus or lower leg. There was one case of perioperative thrombophlebitis of a lateral branch in the lower leg and one case of a third-degree thigh burn with subsequent infection of the great saphenous vein canal. No deep vein thrombosis or pulmonary embolism occurred in any of the operated patients.Of the eleven great saphenous veins treated, one recanalised after 14 months, the others had closed or were no longer detectable on ultrasound. The small saphenous vein treated was also no longer detectable.In one patient, a major recurrence at the saphenofemoral junction with recurrent lateral branches in the thigh and lower leg were determined 168 months after surgery. No recurrent varicosis was determined in the other patients.

Endovenous Laser Ablation for Incompetent Saphenous Vein Combined With Fluoroscopy-Guided Endovenous Foam Sclerotherapy in Varicose Tributaries: Long-Term Follow-up Results

2016 ◽  
Vol 101 (11-12) ◽  
pp. 590-597
Author(s):  
Song Am Lee ◽  
Sang Woo Park ◽  
Ik Jin Yun ◽  
Jae Joon Hwang ◽  
Jun Seok Kim ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Duplex Ultrasound ◽  
Long Term Results ◽  
Foam Sclerotherapy ◽  
Endovenous Laser Ablation ◽  
Percutaneous Sclerotherapy ◽  
Long Term Follow Up

The aim of this study is to describe the long-term results of 980-nm endovenous laser ablation (EVLA) combined with fluoroscopy-guided endovenous foam sclerotherapy using a microcatheter into varicose tributaries. This report reviewed experiences with fluoroscopy-guided endovenous foam sclerotherapy using a microcatheter followed by EVLA, from July 2005 to November 2007. The sclerosing foam was injected through the microcatheter using 1% polidocanol or sodium tetradecyl sulfate. Patients were evaluated clinically and with duplex ultrasound from 1 week to 3 years to assess treatment efficacy and adverse reactions. Technical success was seen in 460 of 461 limbs (99.8%). Continued closure of the saphenous veins and complete sclerosis of varicose tributaries were noted in 351 of 408 limbs (86%) at 1-month follow-up, all 328 limbs at 3-month follow-up, all 299 limbs at 6-month follow-up, all 146 limbs at 1-year follow-up, all 94 limbs at 2-year follow-up, and all 32 limbs at 3-year follow-up. No serious complications were noted. Bruising was noted in 79.0%, and pain or tightness was noted in 68.4%. Hyperpigmentation was noted in 54.2%. EVLA for incompetent saphenous vein combined with endovenous foam sclerotherapy appears to offer the obvious benefits of less additional percutaneous sclerotherapy. However, many problems, like long-lasting pain and hyperpigmentation, can lessen the value of this procedure.

Mechanochemical ablation for symptomatic great saphenous vein reflux: A two-year follow-up

2016 ◽  
Vol 32 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Pamela S Kim ◽  
Muath Bishawi ◽  
David Draughn ◽  
Marab Boter ◽  
Charles Gould ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Saphenous Vein ◽  
Severity Score ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
Mechanochemical Ablation ◽  
Venous Clinical Severity Score ◽  
Occlusion Rate ◽  
The Mean

Background Several studies have shown comparable early efficacy of mechanochemical ablation to endothermal techniques. The goal of this report was to show if early efficacy is maintained at 24 months. Methods This was a two-year analysis on the efficacy of mechanochemical ablation in patients with symptomatic C2 or more advanced chronic venous disease. Patients with reflux in the great saphenous vein involving the sapheno-femoral junction and no previous venous interventions were included. Demographic information, clinical, and procedural data were collected. The occlusion rate of treated veins was assessed with duplex ultrasound. Patient clinical improvement was assessed by Clinical-Etiology-Anatomy-Pathophysiology (CEAP) class and venous clinical severity score. Results Of the initial 126 patients, there were 65 patients with 24 month follow-up. Of these 65 patients, 70% were female, with a mean age of 70 ± 14 years and an average body mass index (BMI) of BMI of 30.5 ± 6. The mean great saphenous vein diameter in the upper thigh was 7.6 mm and the mean treatment length was 39 cm. Adjunctive treatment of the varicosities was performed in 14% of patients during the procedure. Closure rates were 100% at one week, 98% at three months, 95% at 12 months, and 92% at 24 months. There was one patient with complete and four with partial recanalization ranging from 7 to 12 cm (mean length 9 cm). There was significant improvement in CEAP and venous clinical severity score (P < .001) for all time intervals. Conclusion Early high occlusion rate with mechanochemical ablation is associated with significant clinical improvement which is maintained at 24 months, making it a very good option for the treatment of great saphenous vein incompetence.

scholarly journals ClariVein® – Early results from a large single-centre series of mechanochemical endovenous ablation for varicose veins

2016 ◽  
Vol 32 (1) ◽  
pp. 6-12 ◽  
Author(s):  
TY Tang ◽  
JW Kam ◽  
ME Gaunt
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Single Centre ◽  
Foam Sclerotherapy ◽  
Early Results ◽  
Endovenous Ablation ◽  
The Uk

Objectives This study assessed the effectiveness and patient experience of the ClariVein® endovenous occlusion catheter for varicose veins from a large single-centre series in the UK. Methods A total of 300 patients (371 legs) underwent ClariVein® treatment for their varicose veins; 184 for great saphenous vein (GSV) incompetence, 62 bilateral GSV, 23 short saphenous vein (SSV), 6 bilateral SSV and 25 combined unilateral great saphenous vein and SSV. Patients were reviewed at an interval of two months post procedure and underwent Duplex ultrasound assessment. Postoperative complications were recorded along with patient satisfaction. Results All 393 procedures were completed successfully under local anaesthetic. Complete occlusion of the treated vein was initially achieved in all the patients, but at eight weeks’ follow-up, there was only partial obliteration in 13/393 (3.3%) veins. These were all successfully treated with ultrasound-guided foam sclerotherapy. Procedures were well tolerated with a mean pain score of 0.8 (0–10). No significant complications were reported. Conclusions ClariVein® can be used to ablate long and short saphenous varicose veins on a walk-in–walk-out basis. Bilateral procedures can be successfully performed, and these are well tolerated as can multiple veins in the same leg. Early results are promising but further evaluation and longer term follow-up are required.

Comparison of cyanoacrylate embolization and radiofrequency ablation for the treatment of varicose veins

2018 ◽  
Vol 34 (4) ◽  
pp. 278-283 ◽  
Author(s):  
Gary K Yang ◽  
Marina Parapini ◽  
Joel Gagnon ◽  
Jerry C Chen
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Treatment Success ◽  
Vancouver General Hospital ◽  
Wound Complications ◽  
Complication Rates ◽  
Success Rates

Objective To review clinical outcomes of varicose vein patients treated with cyanoacrylate embolization and radiofrequency ablation at our institution. Methods A retrospective review of patients who underwent cyanoacrylate embolization and radiofrequency ablation during a three-year period. Patient records were reviewed to assess demographics, location and severity of disease, treatment details and outcome at short- and mid-term follow-ups. Outcome parameters included treatment success and complications. Results Between January 2014 and December 2016, 335 patients with 476 veins were treated with either cyanoacrylate embolization (n = 148) or radiofrequency ablation (n = 328) at the Vancouver General Hospital Vascular Surgery Vein Clinic. The average age of patients were 57 ± 1 years with the majority being female (78%) and an average BMI of 24.8 ± 0.5. CEAP classes were 2 (49%), 3 (26%), 4a (22%) and >4b (3%). Of the veins treated with cyanoacrylate embolization, the vein types were as follows: 76% were great saphenous vein, 16% were small saphenous vein, 5% were anterior accessory great saphenous vein and 1.4% were perforator veins. The vein types for radiofrequency ablation were 88%, 9%, 3% and 0%, respectively. The average amount of cyanoacrylate embolization delivered for great saphenous vein treatment was 1.8 ± 0.1 ml with a treatment length of 43 ± 1 cm. Subgroup comparison was done for great saphenous vein segments. Treatment success was 100% in cyanoacrylate embolization and 99% in radiofrequency ablation. Superficial phlebitis was the most common complication noted at mid-term follow-up in 5% of cyanoacrylate embolization and 16% of radiofrequency ablation treatments (P < 0.05). One patient in each group had asymptomatic proximal thrombus extension treated with anticoagulation for 2–3 weeks. Three superficial infections from glue clumps were noted in the cyanoacrylate embolization group requiring excision and drainage. Five patients in the radiofrequency ablation group had persistent numbness and one wound complications at the access site. Conclusion Cyanoacrylate embolization offers equivalent success rates with lower mid-term complication rates as radiofrequency ablation.

scholarly journals Transpancreatic biliary sphincterotomy for biliary access is safe also on a long-term scale

2020 ◽  
Vol 35 (1) ◽  
pp. 104-112
Author(s):  
Vilja Koskensalo ◽  
Marianne Udd ◽  
Mia Rainio ◽  
Jorma Halttunen ◽  
Matias Sipilä ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
University Hospital ◽  
Long Term Results ◽  
Biliary Duct ◽  
Complication Rates ◽  
Biliary Sphincterotomy ◽  
Significant Difference ◽  
Upper Abdominal

Abstract Background Transpancreatic biliary sphincterotomy (TPBS) is an advanced cannulation method for accessing common bile duct (CBD) in endoscopic retrograde cholangiopancreatography (ERCP). If CBD cannulation is difficult, an endoscopist can open the septum between the pancreatic and biliary duct with a sphincterotome to gain access. Long-term results of this procedure are unclear. We wanted to evaluate the short- and long-term complications of TPBS on patients with native papilla and benign indication for ERCP. Patients and Methods ERCPs performed in Helsinki University Hospital between 2007 and 2013 were reviewed. The study group comprised 143 consecutive patients with TPBS and 140 controls (CG). Data were collected from patient records and a phone survey was performed as a follow-up ≥ 4 years after the index ERCP. Results Post-ERCP pancreatitis (PEP) developed in seven patients (4.9%) in TPBS and one patient (0.7%) in CG (p = 0.067). The rates of other acute complications were similar between the groups. ERCP ended with no access to CBD in four cases (2.8%) in TPBS. The median length of follow-up was 6 years in TPBS and 7 years in CG. During this period, three patients (2.1%) in TPBS and six patients (4.3%) in CG suffered from acute pancreatitis (AP) (p = 0.238). One (0.7%) patient in CG and none in TPBS developed chronic pancreatitis (CP). Abdominal pain was suffered by ten patients (6.9%) in TPBS and twelve patients (8.6%) in CG daily, whereas by six patients (4.2%) in TPBS and twelve patients (8.6%) in CG weekly. Conclusion TPBS is a useful procedure, with acceptable complication rates. No significant difference occurred between the groups when evaluating the short-term or long-term complications with a follow-up period of four to 10 years. Additionally, no significant differences occurred in upper abdominal pain, episodes of AP, or development of CP.

scholarly journals Long-Term Results of Reconstruction with Pelvic Allografts after Wide Resection of Pelvic Sarcomas

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mehmet Ayvaz ◽  
Senol Bekmez ◽  
M. Ugur Mermerkaya ◽  
Omur Caglar ◽  
Emre Acaroglu ◽  
...  
Keyword(s):  
Functional Results ◽  
Long Term Results ◽  
Wide Resection ◽  
Complication Rates ◽  
Allograft Reconstruction ◽  
Orthopedic Oncology ◽  
Common Causes ◽  
Pelvic Resection

Reconstruction after the resection of a pelvic tumor is a challenging procedure in orthopedic oncology. The main advantage of allograft reconstruction is restoration of the bony architecture of the complex pelvic region. However, high complication rates such as infection and allograft resorption had been reported in the literature. In this study, we aimed to retrospectively review nine patients treated with pelvic resection and structural pelvic allograft reconstruction. Functional results, complications, and survival of the patients and the allografts were evaluated. At a mean follow-up of 79 months, three patients were dead. Major complications were detected in eight of the nine patients. Infection (four of the nine patients) and allograft resorption (three of the nine patients) were the most common causes of failure. The cumulative survival of the patients was 66.7 percent at 70 months. However, allograft survival was only 26.7 percent at 60 months. Mean MSTS score was 69. In conclusion, we suggest that other reconstruction options should be preferred after pelvic resections because of the high complication rates associated with massive allograft reconstruction.

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