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 ◽  
...  

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

Author(s):  
L. CRAEGHS ◽  
B. BECHTER-HUGL ◽  
S. THOMIS ◽  
I. FOURNEAU

Quality of life one year after radiofrequency ablation of the great saphenous vein Symptomatic varicose veins have a negative impact on quality of life. Radiofrequency ablation (RFA) is an endovenous technique to occlude the venous lumen. In this study, the patient satisfaction and patient-reported quality of life is investigated one to two years after RFA of the great saphenous vein (GSV). Questionnaires were sent to 200 patients who were treated with RFA of the GSV at UZ Leuven more than one year ago. Data were processed using SPSS Statistics 24. 98 of 200 patients (49%) participated in this study. 80,4% (78/97) of patients were satisfied and 95,8% (92/96) would choose it all over again. Self image improved in 58,2% (57/98) and general health improved in 29,6% (29/98) of patients compared to a year ago. 57,4% (54/94) of patients had no relapse or progression one year after RFA of the GSV. Dissatisfaction was more common in patients with a history of varicose vein treatment, in patients with recurrent varicose veins or venous symptoms and in patients with postoperative hematoma. RFA of the GSV results in patient satisfaction among the participating patients and has a positive impact on their self image and on health-related quality of life more than a year after the treatment.


Flebologiia ◽  
2020 ◽  
Vol 14 (2) ◽  
pp. 91
Author(s):  
A.S. Volkov ◽  
M.D. Dibirov ◽  
A.I. Shimanko ◽  
R.U. Gadzhimuradov ◽  
S.V. Tsuranov ◽  
...  

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tom Barker ◽  
Felicity Evison ◽  
Ruth Benson ◽  
Alok Tiwari

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.


Author(s):  
S. N. Zhabin ◽  
A. A. Shitikov ◽  
A. V. Tsukanov ◽  
E. G. Obedkov ◽  
S. S. Dudchenko ◽  
...  

Introduction: Lower extremity varicose vein disease is one of the common problems in vascular surgery. Clinically, this disease is accompanied by a wide range of complaints and external symptoms, which eventually lead to a worse patients’ quality of life. The integrated approach is being applied to the disease treatment, which involves the use of various phlebotropic drugs as conservative therapy along with minimally invasive surgical correction and sclerotherapy.Objective: to improve the quality of phlebotropic therapy for patients with lower extremity varicose vein disease, based on the study of factors that shape the patient’s compliance with the effective treatment of clinical symptoms. The term «compliance» means the precise and informed implementation of the doctor’s recommendations during the treatment by the patient. Most often, «compliance» is assessed by the drug use index, which is the quotient of dividing the number of days on which the full dose of the drug was taken by the duration of the entire study period. Materials and methods: The analysis of 368 + 111 patients with lower extremity varicose vein disease was carried out. Of these, 111 patients turned out to be beyond the correct study of compliance (a phlebectomy was performed in a hospital). 368 patients were divided into the following groups: Group 1: the patients, who were assigned modern surgical treatment of varicose veins (endovenous laser coagulation, scleroobliteration); Group 2: the patients, who withdrew from assigned interventions. As it turned out, the different groups of patients differed in compliance.Results. The patients who were shown and performed surgical treatment – 320 (86.9%), can be considered highly compliant with the prescribed conservative therapy – the average value of the compliance index is 0.83, compared to the representatives who refused to perform the recommended surgical procedures recommended by them – 48 (13.1%), the compliance index is 0.78.In the course of the investigation, the factors shaping compliance with phlebotropic drugs were identified, a comparative assessment was carried out on the main indicators of the effectiveness of phlebotropic drugs.Conclusion. Thus, the compliance of the patients suffering from LEVVV during the treatment with phlebotropic drugs varies depending on the multiplicity and convenience of the form of the drug, on the effectiveness of the proposed phlebotropic therapy according to the influence on the complaints and symptoms, on the psychological readiness of the patient to entrust the result of the final treatment of the disease to the surgeon.


2018 ◽  
Vol 34 (4) ◽  
pp. 278-283 ◽  
Author(s):  
Gary K Yang ◽  
Marina Parapini ◽  
Joel Gagnon ◽  
Jerry C Chen

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.


2010 ◽  
Vol 25 (2) ◽  
pp. 79-84 ◽  
Author(s):  
P Marsh ◽  
B A Price ◽  
J M Holdstock ◽  
M S Whiteley

Objectives Early success treating incompetent perforator veins (IPVs) with radiofrequency ablation (RFA) and the trend to move varicose vein surgery into a walk-in walk-out service led to the design of a specific device enabling RFA of IPVs using local anaesthesia (ClosureRFS™ stylet). Our aim was to assess one-year outcomes of a clinical series of patients undergoing treatment with this device. Truncal reflux, where present, was treated initially, and RFA of IPVs was performed as a secondary procedure. Method Duplex ultrasound examinations were performed and the presence of IPVs documented. Results were compared with preoperative scans. IPVs were classified as closed, not closed/reopened or de novo. Results Of the 75 patients invited for follow-up, 53 attended at a median time of 14 months (range 11–25). Sixty-seven limbs were analysed (M:F 1:2.1, median age 62, range 25–81). Of the 124 treated IPVs, 101 were closed (82%). Clinical, aetiological, anatomical and pathological clinical score was improved in 49.3% limbs. IPV closure was reduced in patients with recurrent varicose veins compared with primary varicose veins (72.3% versus 87%, P = 0.056). Conclusion These results demonstrate the radiofrequency stylet device to be an effective treatment for IPVs.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
R. G. Bush ◽  
P. Bush ◽  
J. Flanagan ◽  
R. Fritz ◽  
T. Gueldner ◽  
...  

Background. The goal of this retrospective cohort study (REVATA) was to determine the site, source, and contributory factors of varicose vein recurrence after radiofrequency (RF) and laser ablation.Methods. Seven centers enrolled patients into the study over a 1-year period. All patients underwent previous thermal ablation of the great saphenous vein (GSV), small saphenous vein (SSV), or anterior accessory great saphenous vein (AAGSV). From a specific designed study tool, the etiology of recurrence was identified.Results. 2,380 patients were evaluated during this time frame. A total of 164 patients had varicose vein recurrence at a median of 3 years. GSV ablation was the initial treatment in 159 patients (RF: 33, laser: 126, 52 of these patients had either SSV or AAGSV ablation concurrently). Total or partial GSV recanalization occurred in 47 patients. New AAGSV reflux occurred in 40 patients, and new SSV reflux occurred in 24 patients. Perforator pathology was present in 64% of patients.Conclusion. Recurrence of varicose veins occurred at a median of 3 years after procedure. The four most important factors associated with recurrent veins included perforating veins, recanalized GSV, new AAGSV reflux, and new SSV reflux in decreasing frequency. Patients who underwent RF treatment had a statistically higher rate of recanalization than those treated with laser.


2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Roman Kohan ◽  
Volodymyr Goshchynsky

Nowadays endovenous laser coagulation is the priority method of treatment of lower limb varicose vein disease. However, there are a number of specific complications that reduce efficiency of its usage.The objective of the research was to decrease specific postoperative complications after endovenous laser coagulation due to the introduction of its mathematical design.Materials and methods. The study included 168 patients with lower limb varicose vein disease. Prior to surgery the mathematical calculation of the basic parameters of laser coagulation such as density of laser irradiation and rate of reverse movement of the light pipe depending on the diameter of varicose veins was made. The control group consisted of 146 patients with varicose vein disease; the aforementioned parameters were established according to the instruction of using a laser device.Results.  The analysis of complications such as induration of skin over coagulase great or small saphenous vein, phlebitis in the projection of the great or small saphenous vein, ecchymosis or dermatomelasma in the early postoperative period, pain syndrome showed the reduction in the number of complications while applying the mathematical model of calculation of linear density of laser radiation and the speed of reverse traction of the light pipe with its transfer to the graphic image.Conclusions.  The application of the mathematical model of calculation of linear density of laser radiation and the speed of reverse traction of the light pipe with its transfer to the graphic image allows us to improve the results of endovenous laser coagulation for varicose veins due to the reduction in specific complications.


2021 ◽  
pp. 1-4
Author(s):  
Zierau UT

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.


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