Experience with radiofrequency closure of varicose veins (VNUS)

2005 ◽  
Vol 20 (2) ◽  
pp. 82-86 ◽  
Author(s):  
S K Das ◽  
N Sahoo ◽  
M Shanaz
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Cost Savings ◽  
General Anaesthetic ◽  
Vein Thrombosis ◽  
Long Saphenous Vein ◽  
The One ◽  
Intraoperative Localization ◽  
The Cost ◽  
Deep Vein

Objective: The aim of this study was to reproduce the results of VNUS closure in our setting; to minimize the cost associated with the procedure; and to reduce the need for an experienced ultrasonographer during the procedure. Methods: Over a two-year period, 26 patients (42 limbs) were treated. A VNUS radio-frequency machine was used and assisted by intraoperative localization using Sonosite ultrasound, which was operated by the surgeon. All patients were treated under general anaesthetic. Nine patients were operated as a day case and 17 others stayed overnight. Median follow-up period was seven months. Results: The mean age of the patients was 37 years (range 19–69). Eighteen patients had primary and eight had recurrent varicose veins. Sixteen patients underwent bilateral and 10 underwent the unilateral procedure. Long saphenous vein (LSV) closure was performed in 41 limbs and short saphenous vein closure in two limbs. The LSV was accessed at the ankle in 36 and at knee in three limbs. In two other limbs, groin exploration with retrograde closure of the LSV was achieved. One patient developed numbness at phlebectomy site. None of the patients had deep vein thrombosis and all the treated veins were closed at the one-week scan. In bilateral cases, one catheter was used instead of two for closure in 12 of the 16 limbs. Using our approach, we were able to make a cost savings of £8,600.00. Conclusion: Technical success in radiofrequency vein closure can be achieved without the need for an additional ultrasonographer. We have shown that our approach is safe, effective and less expensive to deliver.

Recurrent varicose veins assessed by colour-coded duplex scanning: own experience

Phlebologie ◽  
2000 ◽  
Vol 29 (03) ◽  
pp. 58-61 ◽  
Author(s):  
G. Madycki ◽  
P. Dabek ◽  
A. Gabrusiewicz ◽  
W. Staszkiewicz
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Preoperative Assessment ◽  
Duplex Scanning ◽  
Group Iii ◽  
Recurrent Varicose Veins ◽  
Long Saphenous Vein ◽  
Group I ◽  
Short Saphenous Vein ◽  
Deep Vein

SummaryAim: Authors performed a retrospective analysis of causes of recurrent varicose veins following surgery. Methods: They evaluated 89 patients (65 women and 24 men, mean age 49.7 years). All patients previously underwent same surgical procedures (long saphenous vein stripping with/without local multiple avulsions). For the purpose of the study, colour/duplex examinations were applied (Siemens Sonoline Elegra unit). Results: Depending on the type and area of recurrent varicose veins, patients were classified into 4 groups. Group I – 22 patients (persistence of varicose tributaries of LSV in thigh or thigh perforator). Group II – 27 patients (recurrence along the LSV in the calf). Group III – 26 patients (recurrence due to left incompetent short saphenous vein). Group IV – 14 patients (isolated incompetent perforators). Authors conclude, that colour-coded duplex scanning is currently a method of choice in the diagnosis of recurrent varicose veins. High incidence of recurrence due to short saphenous vein incompetence should draw particular attention to this vein in the preoperative assessment of venous system. Recurrence of varicose veins at thigh level is not caused by deep vein insufficiency, but is related to inadequate vein surgery or might be linked to the problem of neovascularisation in this area.

Haemodynamic Correction of Varicose Veins (CHIVA): An Effective Treatment?

1996 ◽  
Vol 11 (3) ◽  
pp. 98-101 ◽  
Author(s):  
P. Zamboni ◽  
C.V. Feo ◽  
M. G. Marcellino ◽  
G. Vasquez ◽  
C. Mari
Keyword(s):  
Saphenous Vein ◽  
Continuous Wave ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Vein Thrombosis ◽  
Long Saphenous Vein ◽  
Group A ◽  
Primary Varicose Veins ◽  
Short Saphenous Vein ◽  
Group B

Objective: Evaluation of the feasibility and utility of haemodynamic correction of primary varicose veins (French acronym: CHIVA). Design: Prospective, single patient group study. Setting: Department of Surgery, University of Ferrara, Italy (teaching hospital). Patients: Fifty-five patients with primary varicose veins and a normal deep venous system (ultrasonographic criteria) were studied. Interventions: Fifty-five haemodynamic corrections by the CHIVA method described by Franceschi were undertaken. Seven patients were treated for short saphenous vein varices (group A) while 48 patients were treated for long saphenous vein varices (group B). Main outcome measures: Clinical: presence of varices and reduction in symptoms. Duplex and continuous-wave Doppler detection of re-entry through the perforators and identification of recurrences or new sites of reflux. Postoperative ambulatory venous pressure and refilling time measurements. Patients were studied for 3 years following surgery. Results: In group A, 57% short saphenous vein occlusions with no re-entry through the gastrocnemius and soleal veins were recorded. In group B the long saphenous vein thrombosis rate was 10%. In this group 15% of the patients showed persistence of reflux instead of re-entry at the perforators. Early recurrences were also observed. Overall CHIVA gave excellent results in 78% of the patients. Statistically significant ambulatory venous pressure and refilling time changes were recorded ( p<0.001). Conclusions: CHIVA treatment is inadvisable for short saphenous vein varices. Long saphenous vein postoperative thrombosis is related to development of recurrences

scholarly journals The measurement of venous pressure by Doppler: is it a hemodynamic evaluation ?

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Pier Luigi Antignani ◽  
Giampiero Peruzzi ◽  
Tommaso Spina
Keyword(s):  
Clinical Application ◽  
Saphenous Vein ◽  
Normal Values ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Average Pressure ◽  
Doppler Method ◽  
Vein Thrombosis ◽  
Posterior Tibial ◽  
Long Saphenous Vein

Since 1980 using the Doppler method, planned by Bartolo, we have studied several patients by means of the measurement of venous pressures, both in orthostatism and in clinostatism. In a normal subject, in orthostatism the value of average pressure is 60 mmHg in the posterior tibial vein, and 60 mmHg in the long saphenous vein. When there are varicose veins, the average pressure is 90 and 96 mmHg respectively in the deep veins and in the superficial ones. In the case of post-thrombotic syndrome, the average values are 101 and 102 mmHg in the deep and superficial veins, respectively. In clinostatism, the normal values are under 20 mmHg and in subjects with vein thrombosis the value increase to 30 mmHg and more. After more than 30 years we discuss the reliability of the method, the hemodynamic basis and its clinical application in phlebological practice.

scholarly journals Vein Glue VenaSeal® for the Therapy in Case of Varicose Vein Thrombosis: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Zierau UT
Keyword(s):  
Deep Vein Thrombosis ◽  
Case Report ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Rare Complication ◽  
Vein Thrombosis ◽  
Saphenous Veins ◽  
Deep Vein

The thrombosis in areas of the superficial truncal varicose veins and cutaneous veins is not a rare complication; it requires drug or surgical therapy if the thrombosis grows in the direction of deep veins. This situation is particularly striking in the case of thromboses of the great saphenous vein GSV and small saphenous vein SSV as well as other saphenous veins and leads to deep vein thrombosis in around 20% of cases. We will report about a case of SSV thrombosis and the catheter-based therapy of thrombosis following the therapy of truncal varicose vein SSV with VenaSeal® in one session.

Endovenous Laser Ablation of Varicose Veins: Review of Current Technologies and Clinical Outcome

Vascular ◽  
2007 ◽  
Vol 15 (5) ◽  
pp. 250-254 ◽  
Author(s):  
Colleen M. Johnson ◽  
Robert B. McLafferty
Keyword(s):  
Saphenous Vein ◽  
Laser Energy ◽  
Varicose Veins ◽  
Adult Population ◽  
Causative Factor ◽  
Clinical Results ◽  
Effective Treatment Option ◽  
Vein Thrombosis ◽  
Saphenous Nerve Injury ◽  
Deep Vein

Symptomatic lower extremity varicose veins represent one of the most common vascular conditions in the adult population. Associated symptoms ranged from mild conditions such as fatigue, heaviness, and itching to more serious conditions such as skin discoloration and leg ulceration. The predominant causative factor of this condition is reflux of the great saphenous vein (GSV), which is traditionally treated with surgical saphenofemoral ligation and stripping of the incompetent saphenous vein. In recent years, there have been significant advances in saphenous vein ablation using percutaneous techniques, including the endovenous laser therapy (EVLT). In this article, the authors discuss the therapeutic evolution of this technology, theoretical basis of laser energy in GSV ablation, and procedural techniques of EVLT using duplex ultrasonography. Additional discussion of procedural-related complications, such as deep vein thrombosis, skin burn, saphenous nerve injury, and phletibis, and ecchymosis, are provided. Lastly, clinical results of EVLT in GSV ablation are discussed. Current literatures support EVLT as a safe and effective treatment option for varicosities caused by GSV incompetence.

Venous Flow Resistance and Venous Capacity in Humans with Primary Varicosis of the Long Saphenous Vein

1990 ◽  
Vol 5 (1) ◽  
pp. 31-35 ◽  
Author(s):  
B. J. F. Klein Rouweler ◽  
J. P. Kuiper ◽  
A. J. M. Brakkee
Keyword(s):  
Deep Vein Thrombosis ◽  
Saphenous Vein ◽  
Strain Gauge ◽  
Flow Resistance ◽  
Venous Flow ◽  
Vein Thrombosis ◽  
Long Saphenous Vein ◽  
Venous Capacity ◽  
Deep Vein ◽  
Diagnostic Criterion

Venous flow resistance ( Rv) and venous capacity ( C10) was measured by strain-gauge plethysmography in patients with primary truncal varicosis of the long saphenous vein (LSV). Rv tended to be lower than normal, notably in measurements taken at the foot, but significant differences were hardly demonstrable. C10 in the calf and the foot were significantly higher than normal. Physical and morphological abnormalties of the LSV with relevance to Rv and C10 are discussed. It was demonstrated that the contribution of the LSV to venous haemodynamics amounts to about 10%. It is considered unlikely that the sensitivity of Rv, when used as a diagnostic criterion for recent deep vein thrombosis, is influenced by the LSV.

Injection—Compression Sclerotherapy of the Greater Saphenous Vein with PRoximal Incompetence (Crosse Insufficiency) as an Alternative Treatment to Surgery

1988 ◽  
Vol 3 (1) ◽  
pp. 41-48 ◽  
Author(s):  
K.M. Hoerdegen ◽  
K. Sigg
Keyword(s):  
Saphenous Vein ◽  
Alternative Treatment ◽  
Varicose Veins ◽  
Injection Technique ◽  
Long Saphenous Vein ◽  
Two Factors ◽  
Compression Treatment ◽  
Deep Vein ◽  
Deep Vein Thromboses

Injection compression treatment of the long saphenous vein with proximal incompetence can yield good results if two factors are taken into account: first, a reliable injection technique, executed over many years, and second, a suitable non-toxic sclerosant, which is sufficiently strong to close even the largest varicose veins. The investigation of 88 patients showed in nearly 100% of cases an obliteration of the sapheno-femoral junction and, after a follow-up period from 1 to 10 years, permanent closure of the sapheno-femoral junction in 91.2% was achieved. In using our technique we have never encountered intra-arterial or paravenous injections, nor have we noted deep vein thromboses or pulmonary embolisms.

scholarly journals Comparative analysis of short-term outcomes after surgical treatment of varicose disease with endovasal laser obliteration and short stripping

2021 ◽  
Vol 25 (2) ◽  
pp. 55-62
Author(s):  
A. V. Gavrilenko ◽  
M. V. Ananeva ◽  
P. E. Vakhratyan ◽  
A. N. Kosenkov ◽  
M. M. Musaev
Keyword(s):  
Postoperative Pain ◽  
Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Clinical Severity ◽  
Vein Thrombosis ◽  
Venous Clinical Severity Score ◽  
Ultrasound Findings ◽  
Deep Vein

The purpose of this study was to compare outcomes (within six months) after short stripping (SS) and endovenous laser obliteration (EVLO) in patients with varicose veins when analyzing ultrasound findings, postoperative complications, level of postoperative pain, clinical manifestations, and duration of rehabilitation after the intervention. Patients with varicose veins of lower extremities and insufficiency of large saphenous vein valves had either EVLO or SS with miniflebectomy. All patients were examined before surgery and then in 5 days, 10 days and in 1, 3 and 6 months after it. The patients also had clinical examination, ultrasound duplex scanning of their lower extremity veins; Venous Clinical Severity Score (VCSS) was also used for the trial. Pain was assessed during the first 10 days after the surgery using a 10-point pain assessment scale. 156 patients (177 lower extremities) were followed-up for 6 months. As the results of our study showed, endovenous laser obliteration and short stripping were equally effective in eliminating the reflux of the great saphenous vein (GSV). After 6 months of follow-up, the reflux along the medial inflow was noted in one case in SS group; partial GSV recanalization was noted in one case in EVLO group in 3 months, in 3 cases – in 6 months. Besides, despite LMH preventive doses one patient from EVLO group had EHIT II deep vein thrombosis. The obtained outcomes have demonstrated that EVLO and SS have similar effectiveness and safety. No difference has been found between these two types of treatment, except more pronounced postoperative pain and bruising in SS group. Performed care was equally safe and effective in eliminating GSV reflux, in relieving symptoms and eliminating varicose veins as well as in improving the quality of life. Long-term outcomes, especially the rate of relapses depending on the type of intervention, are to be investigated in future trials.

Evaluation of a New Rapid Quantitative D-dimer Assay in Patients with Clinically Suspected Deep Vein Thrombosis

1996 ◽  
Vol 75 (03) ◽  
pp. 412-416 ◽  
Author(s):  
Armando D’Angelo ◽  
Gabriella D’Alessandro ◽  
Loredana Tomassini ◽  
Jean Louis Pittet ◽  
G Dupuy ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Predictive Value ◽  
Cost Savings ◽  
Pretest Probability ◽  
First Episode ◽  
Consecutive Series ◽  
Vein Thrombosis ◽  
Baseline Testing ◽  
Deep Vein ◽  
D Dimer

SummaryThe sensitivity and specificity for deep vein thrombosis (DVT) of a new rapid, quantitative and precise (total imprecision < 10%) D-dimer assay suitable for individual measurements (VIDAS D-DIMER, bio-Merieux, France) were evaluated in a consecutive series of 103 in- and out-patients submitted to serial compression ultrasonography (C-US) for the clinical suspicion of DVT (n = 66) or of DVT recurrence (n = 37) and symptoms lasting from 1 to 15 days. DVT was found in 22 patients at baseline testing and no patient with an initially negative C-US developed vein incompressibility at follow up. The time elapsed from the onset of symptoms was negatively associated with D-dimer levels both in patients with and in those without DVT. In the entire series of patients, the sensitivity of a positive D-dimer test (≥1.0 Μg/ml) for the presence of DVT was 96% (21/22 patients, 95% confidence interval 75-100%) with a specificity of 75% (64-84%), a negative predictive value of 98% (90-100%), a positive predictive value of 51% (35-67%), and an overall accuracy of 80% (70-87%). A normal D-dimer value (0.22 Μg/ml) was observed in one patient with DVT and symptoms lasting from 15 days. The approach of withholding C-US testing in patients with symptoms lasting from less than 11 days and D-dimer levels below the cut-off value was compared to serial C-US testing alone in a cost-effectiveness analysis subdividing the 66 patients with a first episode according to their clinical pretest probability of DVT. Thrombosis was detected in 6.7% of the patients in the low probability group (n = 15), 16.7% of the patients in the moderate probability group (n = 24), 51.9% of the patients in the high probability group (n = 27) and 8.1% of patients with suspected DVT recurrence. Calculated cost-savings for each DVT diagnosed ranged from 5% in the high pretest probability group to 55% in the low pretest probability group and to 77% in patients with suspected DVT recurrence.The safety of avoiding C-US testing in symptomatic patients with a negative D-dimer test should be evaluated in clinical management studies.

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