Study of quality of life in patients with varicose vein after radiofrequency ablation and ultrasound guided foam sclerotherapy

2021 ◽  
Vol 21 (3) ◽  
Author(s):  
Satyendra K. TIWARY ◽  
Sartaz ALAM ◽  
Pankaj SUREKA ◽  
Puneet KUMAR ◽  
Ajay K. KHANNA
2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 80-87 ◽  
Author(s):  
Mark H Meissner

Varicose veins affect one-quarter to one-third of Western adult populations and consume an increasing amount of health care resources. Much of this increased utilization has been driven by the advent of minimally invasive technology including endovenous thermal ablation, foam sclerotherapy, and more recently mechanicochemical and cyanoacrylate glue ablation. This has largely been driven by patient and physician preferences in the absence of robust evidence that one therapy is truly superior to another. This partially arises from misunderstandings about appropriate outcomes measures and what truly constitutes effective treatment of varicose veins. Technical outcomes, such as saphenous closure rates, have frequently been used as surrogates for effective treatment but are poorly correlated with symptom improvement, quality of life, and risk of recurrence. Although there does appear to be a trend towards higher recurrence with ultrasound-guided foam sclerotherapy, the data are occasionally conflicting and there does not appear to be substantial differences between the various modalities. Similarly, there do not appear to be major differences in late quality of life measures between these treatment options. As long-term differences in recurrence and quality of life are small, overall cost effectiveness is driven primarily by initial treatment costs and ultrasound-guided foam sclerotherapy is the most cost-effective strategy in many models. However, there continues to be substantial uncertainty surrounding cost estimates and other factors of importance to the patient may ultimately drive treatment decisions. The benefits of some adjuncts to the treatment of axial superficial reflux, such as the concurrent versus staged management of tributary varicosities, remain ill-defined while that of others, such as routine post-procedural ultrasound surveillance and compression, need critical re-evaluation.


2020 ◽  
Vol 19 ◽  
Author(s):  
Guilherme Camargo Gonçalves de Abreu ◽  
Otacílio de Camargo Jr. ◽  
Márcia Fayad Marcondes de Abreu ◽  
José Luis Braga de Aquino

Abstract Background Chronic Venous Disease (CVD) is the main cause of chronic leg ulcers. Varicose veins are the most frequent cause of venous leg ulcers (VLU). 50.9% of Brazilian women have varicose veins and ulcer prevalence is as high as 4%. Ultrasound-guided foam sclerotherapy (UGFS) is a low-cost treatment option for varicose veins. Objectives To analyze UGFS outcomes in patients with VLU. Methods Prospective consecutive single center cohort study. Patients with great saphenous vein (GSV) reflux and VLU were treated and followed-up for 180 days. The following were studied: quality of life (QoL), disease severity, healing, and elimination of GSV reflux. The Aberdeen questionnaire, a venous clinical severity score, and Duplex scanning (DS) results were analyzed. Results 22 patients aged 35 to 70 years were treated. There was improvement in quality of life, disease severity reduced, and ulcer diameter reduced (p < 0.001; ANOVA). 77.27% of VLU healed completely (95%CI: 59.76-94.78%). The dimensions of 20/22 VLU reduced (90.91%; 95%CI: 78.9-100%). GSV reflux was eliminated in 63.64% (95%CI: 43.54-83.74%). Men had greater QoL benefit and women had more complications. There were no severe complications. The VLU that had healed completely at the end of the study were smaller at baseline than those that did not completely heal. The GSV that were completely occluded at the end of the study were smaller at baseline than those that were not completely occluded (p < 0.05; Mann-Whitney). Conclusion The results suggest that most patients benefited from UGFS.


2017 ◽  
Vol 12 (3) ◽  
pp. 145-154 ◽  
Author(s):  
Arif Ahmed ◽  
Divesh Arora

Introduction: The knee arthroplasty is the best option for patients with advanced osteoarthritis who have failed all other conservative options, but regrettably many patients fail to undergo surgery due to co-morbidities or other reasons. So, new alternative modes are always in demand for these patients. Methods: The ultrasound-guided radiofrequency ablation (RFA) of all the genicular nerves of knee joint was done in patients with grade III and IV osteoarthritis of knee joint, with severe pain (numerical rating scale (NRS) > 7) who had failed conservative management and intra-articular injections after a positive genicular nerve block with local anaesthetics. The demographics, pain intensity measured in NRS, Oxford Knee Score (OKS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and quality of life measured by 36-Item Short Form Health Survey (SF-36) questionnaire was measured at baseline and at regular intervals. Results: The average age of the patients was 61.50 ± 6.75 years. There was significant improvement in pain intensity at rest, movement and on weight bearing from 8.75 ± 0.5, 9.0 ± 0.0, and 9.0 ± 0.0 at baseline to 2.38 ± 0.51, 3.75 ± 0.46, and 4.13 ± 0.35 at 1 month and 3.13 ± 0.64, 4.38 ± 0.51, and 4.63 ± 0.51 at 6 months after the procedure, respectively (p value <0.05). The OKS had improved from 7.75 ± 1.25 at baseline to 28.88 ± 2.53 and 28.13 ± 1.80 at 1 and 6 months, respectively, after the procedure (p value <0.05). The WOMAC score had also improved significantly from 77.75 ± 4.34 at baseline to 38.38 ± 5.82 and 39.25 ± 5.12 at 1 and 6 months, respectively (p value <0.05). There was also significant improvement in the quality of life after the procedure (p value <0.05). Conclusion: Ultrasound-guided RFA of genicular nerves of knee joint is a good alternative option for patients who are having severe pain and disability from knee osteoarthritis and gives a long-lasting pain relief for more than 6 months.


2015 ◽  
Vol 14 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Felipe Coelho Neto ◽  
Gilson Roberto Araújo ◽  
Iruena Moraes Kessler

BACKGROUND: Ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment.OBJECTIVES: To examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency.METHODS: Thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy.RESULTS: Statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001). A similar improvement was also seen in the work and social domains of quality of life (p<0.0001).CONCLUSIONS: As confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications.


2019 ◽  
Vol 35 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Jorgete B dos Santos ◽  
Walter Campos Júnior ◽  
Rina MP Porta ◽  
Juliana Puggina ◽  
Daniela FT da Silva ◽  
...  

Objectives To compare the effectiveness of two foam sclerotherapy techniques of the great saphenous vein. Methods Fifty subjects with varicose veins, edema, and great saphenous vein incompetence (diameter 6–10 mm) were randomly categorized into two equal groups and were treated with different foam sclerotherapy techniques: A (usual ultrasound-guided) and B (catheter-directed with tumescence). Concomitant phlebectomy was performed in all patients. Patients were seen on days 7 and 28, and at six and 12 months. The primary outcomes were the full success rate of the treated great saphenous vein and the number of patients who required retreatment sessions performed at 28-day follow-up. The secondary-assisted outcomes were the full success rates of the treated great saphenous vein after the retreatment sessions at six- and 12-month follow-up. Secondary outcomes were changes in quality of life and side effects and complications of the intervention. In case of reflux, retreatment sessions were performed at 28 days and six months in both groups. Results Full success rate of the treated great saphenous vein was 36% in group A vs. 80% in group B ( p = 0.012) and the number of patients who required retreatment sessions were n = 14 in group A vs. n = 3 in group B at 28-day follow-up ( p = 0.002). Both were statistically significant. At six and 12 months, the success rates were not statistically significant between the groups. Complication rates were similar between the groups. Quality of life improved in both groups with statistical difference ( p < 0.001). Conclusions Catheter-directed foam sclerotherapy with tumescence was better than usual ultrasound-guided foam sclerotherapy as it reached higher full success rate of the treated great saphenous vein and as a lower number of patients required retreatment sessions in the short-term. Both methods proved to be safe and improved the quality of life.


2010 ◽  
Vol 51 (4) ◽  
pp. 913-920 ◽  
Author(s):  
Katy A.L. Darvall ◽  
Rachel C. Sam ◽  
Gareth R. Bate ◽  
Stanley H. Silverman ◽  
Donald J. Adam ◽  
...  

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