scholarly journals Characteristics of Varicose Vein Patients Underwent Endovenous Laser Ablation (EVLA) in Vascular and Endovascular Surgery Sub-Division of Dr. Mohammad Hoesin General Hospital Palembang Between January 2019 - December 2019

2021 ◽  
Vol 4 (2) ◽  
pp. 273-285
Author(s):  
Deo Valendra ◽  
Kemas Muhammad Dahlan
Keyword(s):  
Laser Ablation ◽  
General Hospital ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Endovascular Surgery ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Age Group ◽  
Care Providers ◽  
Endovenous Laser Ablation

Background: Chronic venous disease is often overlooked by health care providers because it has mild symptoms and low mortality. The most common manifestations of chronic venous disease are varicose veins. Risk factors for varicose veins are multifactorial. We aim to determine the characteristics of varicose vein patients who underwent endovenous laser ablation (EVLA). Method: This research is a retrospective descriptive study and was conducted in January 2019 - December 2019 at the Vascular and Endovascular Surgery Sub-division of the General Hospital dr. Mohammad Hoesin Palembang. The samples were all of varicose vein patients who underwent EVLA and was collected with total sampling. The variables used include age, gender, level of severity/grading, and management. The data obtained were processed descriptively and were presented in tabular and narration. Result: There were 24 subjects meeting research critera. The highest age group for varicose veins was in the age group 55 to 74 years as many as 11 people (45.8%). The most varicose vein patients were found in male as many as 14 people (58.3%). Based on the grading of severity, most were in grade C5, namely 14 people (58.3%). In varicose vein patients based on the type of intervention, the most cases occurred with EVLA and phlebotomy as many as 22 people (91.7%). Most subjects did not experience postoperative recanalization, namely 22 people (91.7%). Conclusion: Male patients aged 55 to 74 years old, with severity grade of C5, treated with EVLA and phlebotomy, and without post-operative complication of recanalization are all the most common characteristics of varicose veins patients in dr Mohammad Hoesin General Hospital Palembang.

Endovenous laser ablation is an effective treatment for great saphenous vein incompetence in teenagers

2015 ◽  
Vol 31 (3) ◽  
pp. 198-202
Author(s):  
Piotr Terlecki ◽  
Stanislaw Przywara ◽  
Marek Iłżecki ◽  
Karol Terlecki ◽  
Piotr Kawecki ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Current Knowledge ◽  
Varicose Veins ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Invasive Treatment ◽  
Endovenous Laser Ablation

Objectives The current knowledge of chronic venous disease in teenagers and its treatment is very limited. The aim of the study is to present our experience and the available literature data on the treatment of varicose veins in teenagers with endovenous laser ablation of the great saphenous vein. Methods Five patients, aged 15–17 years, were qualified for surgery, based on typical signs and symptoms of chronic venous disease. Minimally invasive treatment with endovenous laser ablation of the great saphenous vein was applied. Results The technical success of surgery was achieved in all patients. Over a 2-year follow-up we did not observe any case of recanalisation of the great saphenous vein, recurrence of varicose veins, or serious complications, such as deep vein thrombosis or pulmonary embolism. One patient presented with resolving of post-operative bruising, and two cases of local numbness were transient. Conclusions Endovenous laser ablation of the great saphenous vein in the treatment of chronic venous disease in teenagers is effective and safe. The method provides excellent cosmetic effects, very short recovery time and high levels of patient satisfaction.

Global search demand for varicose vein information on the internet

2014 ◽  
Vol 30 (8) ◽  
pp. 533-540 ◽  
Author(s):  
Joseph El-Sheikha
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Healthcare Spending ◽  
Global Search ◽  
Chronic Venous Disease ◽  
Development Economic ◽  
The Internet ◽  
Venous Disease ◽  
Private Healthcare ◽  
Per Capita

Background Changes in internet search trends can provide healthcare professionals detailed information on prevalence of disease and symptoms. Chronic venous disease, more commonly known as varicose veins, is a common symptomatic disease among the adult population. This study aims to measure the change in global search demand for varicose vein information using Google over the past 8 years. Methods The Google Trends instrument was used to measure the change in demand for the use of the local name for varicose veins in several countries across the world between January 2006 and December 2012. The measurements were normalised onto a scale relative to the largest volume of search requests received during a designated time and geographical location. Comparison of national levels of private healthcare and healthcare spending per capita to search demand was also undertaken using Organisation for Economic Co-operation and development economic measurements. Results Global interest has increased significantly, with linear regression demonstrating a 3.72% year-on-year increase in demand over the 8-year time period (r2 = 0.385, p < 0.001). Annual demand significantly increased in the northern hemisphere (p < 0.001 Friedman) yet decreased in the southern hemisphere (p < 0.001 Friedman). Significant seasonality was observed, with warmer months experiencing greater search demand compared to cooler winter months (<0.001 Kruskal–Wallis). National levels of private healthcare did not appear to correlate in search demand (r2 = 0.120 p = 0.306). Healthcare spending per capita did not relate to search demand (r2 = 0.450 p = 0.077). Conclusion There is increasing demand for information about varicose veins on the internet, especially during the warmer months of the year. Online search demand does not appear to be related to healthcare spending.

Endovenous laser ablation in patients with wide diameter of the proximal segment of the great saphenous vein: Comparison of methods

2014 ◽  
Vol 30 (10) ◽  
pp. 700-705 ◽  
Author(s):  
V Starodubtsev ◽  
M Lukyanenko ◽  
A Karpenko ◽  
P Ignatenko
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Chronic Venous Disease ◽  
Proximal Segment ◽  
Venous Disease ◽  
Endovenous Laser Ablation ◽  
Safety And Efficacy ◽  
Wide Diameter ◽  
Saphenous Veins

Objective To estimate the safety and efficacy of using the laser 1560 nm wavelength for treatment of chronic venous disease in patients with wide diameters of the proximal segment of the great saphenous vein. Methods In the study 88 patients with lower limb varicose veins were included. Maximum diameter of the great saphenous vein proximal segment varied from 15 to 34 mm (22 ± 2.3) in all patients. In the 1st group in 34 cases crossektomy and endovenous laser ablation (EVLA) were performed. In the 2nd group in 30 cases EVLA regardless diameter of the great saphenous vein proximal segment was performed. In the 3rd group in 34 cases EVLA taking into account the diameter of the great saphenous vein proximal segment was performed. The laser 1560 nm wavelength was used. Linear endovenous energy density in the 1st and 2nd groups was 90 J/cm for the proximal segment and trunk of great saphenous vein. Linear endovenous energy density in the 3rd group was personalized on the size of the veins: 100 J/cm for diameter of great saphenous vein proximal segment 15–20 mm, 150 J/cm for diameter 20–30 mm, 90 J/cm for middle and distal segments of great saphenous vein. Results In the 1st group obliteration of the trunk of the great saphenous veins and accessory great saphenous veins in all cases without additional interventions was reached. In the 2nd group at four cases (13.3%) the second procedure EVLA was carried out, after which the obliteration of the trunk was achieved. In the 3rd group the obliteration of the trunk of great saphenous vein was achieved without additional interventions. Conclusion Our experience of using the laser 1560 nm wavelength for the treatment of the chronic venous disease in patients with wide diameter of the proximal segment of great saphenous vein shows the safety and efficacy of this technique. EVLA has to be personalized on the size of the segments of vein in patients with wide proximal segment of great saphenous vein.

SHORTTERM FOLLOW UP OF EVLA: COMPLICATIONS AND MANAGEMENTS, A SINGLE CENTER EXPERIENCE OF BANGLADESH

2020 ◽  
pp. 10
Author(s):  
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Large Population ◽  
Venous Disease ◽  
Ablation Therapy ◽  
Single Center Experience ◽  
Below The Knee ◽  
Pregnancy And Delivery

Dodd and Cockett defined varicose veins, saying “a varicose vein is one which has permanently lost its valvular efficiency.” [1] Varicose veins constitute a progressive disease, remission of the disease does not occur, except after pregnancy and delivery. [2] The first documented reference of varicose veins was found as illustrations on Ebers Papyrus dated 1550 B.C. in Athens. [3]Greek philosopher Hippocrates (460-377 B.C.) described the use of compressive bandages and was advisor of small punctures in varicose veins. First patient who underwent operation for his varicose vein appears to be Canus Marius, the Roman tyrant. Giovanni Rima (1777-1843) introduced mid thigh ligation of the saphenous vein. Ligation of the sapheno-femoral junction as it is practiced today was first described by John Homans in his paper in 1916. [2] The Mayo Brothers, postulating that there would be additional benefit in removing the saphenous vein, pursued excision of the GSV through an incision extending from the groin to below the knee. The final technologic leap was introduction of the intraluminal stripper by Babcock. [2] In the era of minimally invasive surgery, the first documented case of Endovenous Laser Ablasion was published in 1999 using 810 nm Diode Laser. Since then several wavelengths were introduced; 810, 940, 980, 1064, 1320, 1470 and newly introduced 1940 nm. [4, 5] It is generally agreed that varicose veins affect from 40 to 60% of women and 15 to 30% men. [6] During the 1930s to 1960s, several large studies reported the prevalence of varicose veins to roughly average 2% in the general population. [7] However, more recently, large population studies such as Edinburgh Vein Study demonstrated an age-adjusted prevalence of truncal varices of 40% in men and 32% in women. [8] Vein ablation is the most modern treatment option for superficial venous disease. Several endovenous modalities are getting popular for the treatment of varicose vein. Endovenous laser ablation therapy is the first endovenous procedure that had made the revolution in the treatment of varicose vein. [9] In Bangladesh, Laser ablation was first started at another center with 980 nm bare fiber and a good number of cases were done. We introduced ELVeSᴿ Radialᴿ fiber for the first time in the country using biolitecᴿ LEONARDOᴿ Mini 1470 nm during last week of March, 2018.

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.

scholarly journals A variant of the castor zinc finger 1 (CASZ1) gene is differentially associated with the clinical classification of chronic venous disease

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Gregory T. Jones ◽  
Judith Marsman ◽  
Luba M. Pardo ◽  
Tamar Nijsten ◽  
Marianne De Maeseneer ◽  
...  
Keyword(s):  
Zinc Finger ◽  
Varicose Vein ◽  
Risk Allele ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Enhancer Activity ◽  
Lower Severity

Abstract Recent reports have suggested a reproducible association between the rs11121615 SNP, located within an intron of the castor zinc finger 1 (CASZ1) gene, and varicose veins. This study aimed to determine if this variant is also differentially associated with the various clinical classifications of chronic venous disease (CVD). The rs11121615 SNP was genotyped in two independent cohorts from New Zealand (n = 1876 controls /1606 CVD cases) and the Netherlands (n = 1626/2966). Participants were clinically assessed using well-established CVD criteria. The association between the rs11121615 C-allele and varicose veins was validated in both cohorts. This was strongest in those with higher clinical severity classes and was not significant in those with non-varicose vein CVD. Functional analysis of the rs11121615 variant demonstrated that the risk allele was associated with increased enhancer activity. This study demonstrates that the CASZ1 gene associated C-allele of rs11121615 has a significant, reproducible, association with CVD (CEAP C ≥ 2 meta-odds ratio 1.31, 95% CI 1.27–1.34, P = 1 × 10−98, PHet = 0.25), but not with non-varicose vein (CEAP C1, telangiectasia or reticular veins) forms of venous disease. The effect size of this association therefore appears to be susceptible to influence by phenotypic heterogeneity, particularly if a cohort includes a large number of cases with lower severity CVD.

The effect of endovenous laser ablation on restless legs syndrome

2008 ◽  
Vol 23 (3) ◽  
pp. 112-117 ◽  
Author(s):  
C A Hayes ◽  
J R Kingsley ◽  
K R Hamby ◽  
J Carlow
Keyword(s):  
Laser Ablation ◽  
Restless Legs Syndrome ◽  
Rating Scale ◽  
Varicose Veins ◽  
Complete Relief ◽  
Venous Disease ◽  
Endovenous Laser Ablation ◽  
Restless Legs ◽  
Irls Score

Objectives Venous disease was proposed as a cause of restless legs syndrome (RLS) by Dr Karl A Ekbom in 1944, but has since remained largely unexplored. This study examines the effect of endovenous laser ablation (ELA) in patients with concurrent RLS and duplex-proven superficial venous insufficiency (SVI). Methods Thirty-five patients with moderate to very severe RLS (as defined by the 2003 National Institute of Health (NIH) RLS criteria) and duplex-proven SVI completed an international RLS rating scale questionnaire (IRLS) and underwent standard duplex examination to objectively measure the baseline severity of their conditions. They were separated into non-operative and operative cohorts. The operative cohort underwent ELA of refluxing superficial axial veins using the CoolTouch CTEV 1320 nm laser and ultrasound-guided sclerotherapy of the associated varicose veins with foamed sodium tetradecyl sulphate (STS). All patients then completed a follow-up IRLS questionnaire. Baseline and follow-up IRLS scores were compared. Results Operative correction of the SVI decreased the mean IRLS score by 21.4 points from 26.9 to 5.5, corresponding to an average of 80% improvement in symptoms. A total of 89% of patients enjoyed a decrease in their score of ≥15 points. Fifty-three percent of patients had a follow-up score of ≤5, indicating their symptoms had been largely alleviated and 31% had a follow-up score of zero, indicating a complete relief of RLS symptoms. Conclusions ELA of refluxing axial veins with the CTEV 1320 nm laser and foamed STS sclerotherapy of associated varicosities alleviates RLS symptoms in patients with SVI and moderate to very severe RLS. Recommendations SVI should be ruled-out in all patients with RLS before initiation or continuation of drug therapy.

scholarly journals Epidemiological analysis of 869,220 varicose vein surgeries over 12 years in Brazil: trends, costs and mortality rate.

2021 ◽  
Author(s):  
Marcela Juliano Silva ◽  
Andressa Cristina Sposato Louzada ◽  
Marcelo Fiorelli Alexandrino da Silva ◽  
Maria Fernanda Cassino Portugal ◽  
Marcelo Passos Teivelis ◽  
...  
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Health System ◽  
Varicose Vein ◽  
Public Health System ◽  
Varicose Veins ◽  
Average Rate ◽  
Public Hospitals ◽  
Chronic Venous Disease ◽  
Venous Disease

Objectives: to assess the total numbers of surgical procedures performed between 2008 and 2019 for the treatment of varicose veins in the Public Health System, which exclusively insures more than 160 millions Brazilian, the distribution of the surgeries over time, as well as its costs and mortality rates. Design, Materials and Methods: data referring to surgeries to treat chronic venous disease between 2008 and 2019 were extracted from the database of the Brazilian Public Health System. Results: In total, 869,220 surgeries were performed to treat chronic venous disease in public hospitals and outpatient clinics in Brazil, with an average rate of 4,52 surgeries per 10,000 inhabitants per year. From 2015 on, we observe a slight downward trend in the total number of procedures. The total amount reimbursed by the government was US$ 266,628,181.69. A total of 49 deaths were registered following varicose vein surgery, corresponding to a mortality rate of 0.005%. Conclusions: a total of 869,220 surgeries were performed to treat varicose in twelve years, with an overall rate of 4.52 procedures per 10,000 inhabitants per year. The mortality rate was very low, 0.005%.

scholarly journals Great saphenous vein mechanochemical sclerotherapy versus laser ablation in treatment of varicose vein

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M I Ibrahim ◽  
K A Nabil ◽  
A M Abdalmageed ◽  
G K Hussein
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Procedural Pain ◽  
Procedure Time ◽  
Endovenous Laser Ablation ◽  
High Incidence

Abstract Background Endovenous thermal techniques, such as endovenous laser ablation (EVLA), are the recommended treatment for truncal varicose veins. But it requires the administration of tumescent anaesthesia, which can be uncomfortable. Non-thermal, non-tumescent techniques, such as mechanochemical ablation (MOCA) have some advantages such as less post-procedural pain and less procedure time . MOCA combines physical damage to endothelium using sharply terminated metal claws, with the injection of a liquid sclerosant. Introduction Chronic venous insufficiency is one of the most common medical conditions among highly developed societies. The majority of patients (70%) suffer from saphenous veins incompetency. The aim of this study was to evaluate the primary efficacy of mechanochemical sclerotherapy by phlebogriffe (flebogrif) in comparison to laser ablation in treatment of varicose vein. Methods/Design The study was conducted on 30 patients, including 16 women and 14 men divided into 2 groups. The first group (15 patients) was treated with ablation with Flebogrif (MOCA) to treat varicose veins. The second group (15 patients) was treated with ablation with Endovenous laser ablation (EVLA). All patients were qualified based on the ultrasound in a standing position confirming incompetence of the great saphenous vein or small saphenous vein. The primary outcomes are intra-procedural pain and technical efficacy at 1 year, defined as complete occlusion of target vein segment and assessed using duplex ultrasound. Secondary outcomes are post-procedural pain, analgesia use, procedure time, clinical severity, bruising, complications, satisfaction, time taken to return to daily activities and/or work, and cost-effectiveness analysis following EVLA or MOCA. Both groups will be evaluated on an intention-to-treat basis. Results The total primary obliteration rate after 3 days and 1 month was 100% with both EVLA-RTF and MOCA while after 3 months (ms) was 93.3% with both groups. After 6ms the total primary obliteration rate was 93.3% with EVLA-RTF and 86.7% with MOCA. The Venous Clinical Severity Score (VCSS) presented similar and durable improvements in both groups between 3days and 6 months. While there is significant less post procedural pain, ecchymosis and bruises with the MOCA method and so high incidence of use of analgesics in EVLA patients than in MOCA group. The median time for return to work was 1 day after both treatments. No severe adverse events were observed. Discussion The aim of the study is to evaluate whether MOCA is superior to EVLA. The two main hypotheses are that MOCA may cause less initial pain and disability allowing rapid post-operative recovery. The second hypothesis is the efficacy, which may lead to increased recurrence and affect longer term quality of life, increasing the requirement for secondary procedures. Conclusions EVLA and MOCA have similarly high great saphenous vein (GSV) obliteration rates in the long term, and the treatments are equally effective clinically. While according to post procedural pain, ecchymosis, Bruises and long procedural time. The study showed significant high incidence of occurrence in EVLA group than MOCA group. So according to these items there is significant superiority of MOCA over EVLA.

Progression in venous pathology

2015 ◽  
Vol 30 (1_suppl) ◽  
pp. 95-97 ◽  
Author(s):  
F Pannier ◽  
E Rabe
Keyword(s):  
Varicose Vein ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Skin Changes ◽  
Venous Leg Ulcers

Aim To review epidemiologic data on progression of venous pathology in varicose veins and from varicose veins towards chronic venous insufficiency. Methods We searched Medline and PubMed for epidemiologic studies concerning progression of venous pathology. Results The data suggest that reflux progression may develop from segmental to multisegmental superficial reflux. In younger age, reflux in tributaries and non-saphenous veins is more frequent. In older age, more saphenous reflux develops and more proximal sites seem to be affected. A high proportion of uncomplicated varicose vein (C2) develops skin changes and chronic venous insufficiency (C3–C6). Significant risk factors for the progression of varicose vein towards venous leg ulcers are skin changes, corona phlebectatica, higher body mass index and popliteal vein reflux. During a 13.4-year follow-up period, 57.8% (4.3%/year) of all chronic venous disease patients showed progression of the disease. Summary Studies on the progression of venous pathology show a high progression rate of chronic venous disease. More follow-up studies are still needed to get better information about the risk of varicose vein patients for progression to venous leg ulcers and to answer the question which patients may benefit from early varicose vein interventions.

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