Endovenous laser therapy in varicose veins-recanalization rate and quality of life

Purpose The purpose of this systematic review and meta-analysis is to synthesise the available evidence of randomised controlled trials comparing endovenous laser therapy to traditional open surgery, high ligation and stripping, for the treatment of great saphenous vein varicose veins in terms of clinical effectiveness, patient satisfaction and peri-operative complications. Methods MEDLINE, CINAHL, EMBASE and the Cochrane library were searched to identify eligible studies. All randomised controlled trials comparing endovenous laser therapy to high ligation and stripping that used ultrasound examination as an outcome measure and had follow up of one year or more were included. The Cochrane Collaboration’s tool for assessing risk of bias was also used to assess the methodological quality of the included studies. Pooled risk ratios with 95% confidence intervals were used as the measure of effect for each dichotomous outcome. Findings Nine eligible publications relating to six randomised controlled trials were identified. The total enrolment of the studies was 1289 limbs. The clinical efficacy of endovenous laser therapy is comparable to that of surgery in the relatively short follow up period described in the studies. Meta-analysis revealed a trend towards a higher risk of ultrasound recurrence after endovenous laser therapy at 12 months. Quality of life questionnaires reveal similar outcomes for endovenous laser therapy and surgery. There is low quality evidence to suggest surgery is associated with more pain, sensory complications and infection. Conclusion Endovenous laser therapy is a safe alternative to traditional open surgery. There is some weak evidence to suggest that endovenous laser therapy has a higher risk of ultrasound-detected recurrence at 12 months following treatment compared to open surgery. However, it may be associated with less sensory complications, pigmentation and infection.

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Quality of life (QoL) after laser therapy for the management of fibromyalgia: a systematic review

Mechanisms and Techniques in Photodynamic Therapy and Photobiomodulation ◽

10.1117/12.2577292 ◽

2021 ◽

Author(s):

Mariana Pedrazzi Moretti ◽

Beatriz Nascimento Motta ◽

Mariana Monteiro ◽

Rebeca Cecatto

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Laser Therapy

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ASSESSMENT OF RISK FACTORS AND QUALITY OF LIFE AMONG NURSES WITH VARICOSE VEINS AT TERTIARY HEALTH CARE HOSPITALS, CHENNAI

IDC International Journal ◽

10.47211/idcij.2020.v07iws02.006 ◽

2020 ◽

Vol 7 (WS02) ◽

pp. 24-30

Author(s):

Savithri K.B. I ◽

Dr. Raj Rani

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Health Care ◽

Varicose Veins

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Quality of Life After Laser Therapy in Patients with Inoperable Cancer of the Esophagus and Gastric Cardia

Recent Advances in Diseases of the Esophagus ◽

10.1007/978-4-431-68246-2_165 ◽

1993 ◽

pp. 1003-1006

Author(s):

A. Moraldi ◽

P. Ginevri ◽

C. Iascone ◽

S. Stipa ◽

C. U. Casciani

Keyword(s):

Quality Of Life ◽

Laser Therapy ◽

Gastric Cardia ◽

Cancer Of The Esophagus

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A prospective observational cohort study of concomitant versus sequential phlebectomy for tributary varicosities following axial mechanochemical ablation

Phlebology The Journal of Venous Disease ◽

10.1177/0268355519835625 ◽

2019 ◽

Vol 34 (9) ◽

pp. 627-635 ◽

Cited By ~ 4

Author(s):

Abduraheem Mohamed ◽

Clement Leung ◽

Louise Hitchman ◽

Tom Wallace ◽

George Smith ◽

...

Keyword(s):

Quality Of Life ◽

Varicose Veins ◽

Patient Choice ◽

Clinical Severity ◽

Concomitant Treatment ◽

Mechanochemical Ablation ◽

Severity Scores ◽

Secondary Procedures ◽

One Year

Introduction Endovenous mechanochemical ablation (MOCA) is an increasingly popular non-thermal non-tumescent technique used to treat axial reflux in patients with superficial venous incompetence. However, the optimal management of varicose tributaries following this technique is unknown and may impact on patient outcomes. This study compares MOCA with concomitant phlebectomy (MOCAP) versus ablation with sequential phlebectomy if required (MOCAS). Methods Patients with symptomatic Comprehensive Classification System for Chronic Venous Disorders (CEAP C2–C6) unilateral axial reflux were studied. Patient choice determined whether concomitant treatment of varicosities was carried out. The primary outcome was the Aberdeen Varicose Veins Questionnaire (AVVQ) at one year. Secondary outcomes included: Venous Clinical Severity Scores (VCSS), EuroQol 5-Domain quality of life scores, complications, procedure duration, procedural and post-operative pain scores and need for secondary procedures. Outcomes were assessed at baseline and then one week, six weeks, six months and one year post intervention. Results Fifty patients underwent MOCAP and 33 patients MOCAS. The two groups were comparable at baseline. MOCAP was associated with lower (better) AVVQ scores at six weeks (3.4 (0.5–6.0) vs. 6.1 (1.8–12.1); P = 0.009) and at six months (1.6 (0.0–4.5) vs. 3.34 (1.8–8.4); P = 0.009) but by one year the difference was no longer statistically significant (1.81 (0.0–4.5) vs. 3.81 (0.2–5.3); P = 0.099). MOCAP was associated with longer procedural duration (45 min (36–56) vs. 30 min (25–37); P < 0.001) and higher maximal periprocedural pain (31 (21–59) vs. 18 (7–25); P = 0.001). VCSS at all time points were lower in favour of MOCAP (0 (0–1) vs. 1 (0–3); P < 0.001). MOCAP was associated with fewer episodes of clinically significant thrombophlebitis (6 of 50 (12%) vs. 10 of 33 (30%); P = 0.039) and lower numbers of secondary procedures (2 (4%) vs. 6 (18%); P = 0.032). Conclusion Concomitant treatment of tributary varicosities following MOCA improves quality of life and clinical severity, while reducing rates of re-intervention and post-operative thrombophlebitis compared to sequential treatment. The penalty is a modest increase in procedural duration and discomfort. Further evidence from longer-term follow-up is needed.

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Prenatal diagnosis of Klippel–Trenaunay syndrome: Series of four cases and review of the literature

Ultrasound ◽

10.1177/1742271x19880327 ◽

2019 ◽

Vol 28 (2) ◽

pp. 91-102

Author(s):

Olga Ivanitskaya ◽

Elena Andreeva ◽

Natalia Odegova

Keyword(s):

Quality Of Life ◽

Prenatal Diagnosis ◽

Soft Tissue ◽

Varicose Veins ◽

Port Wine ◽

Review Of The Literature ◽

Unique Case ◽

Port Wine Stains ◽

Klippel Trenaunay Syndrome

Klippel–Trenaunay syndrome is a rare disease with a classic triad of port wine stains, varicose veins, and bony and soft tissue hypertrophy of an extremity. The quality of life in these patients is significantly affected, making the prenatal diagnosis of Klippel–Trenaunay syndrome important. We present four prenatally diagnosed cases of this anomaly with a unique case of ectrodactyly of the hand in foetus with Klippel–Trenaunay syndrome. Such a combination has not been previously reported prenatally. A review of the literature for similar cases is also presented.

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The effectiveness of various interventions versus standard stripping in patients with varicose veins in terms of quality of life

Phlebology The Journal of Venous Disease ◽

10.1177/0268355517720307 ◽

2017 ◽

Vol 33 (7) ◽

pp. 439-450 ◽

Cited By ~ 5

Author(s):

Christos Argyriou ◽

Christos Papasideris ◽

George A Antoniou ◽

Efstratios Georgakarakos ◽

Nikolaos Papanas ◽

...

Keyword(s):

Quality Of Life ◽

Varicose Veins ◽

Meta Analysis ◽

Assessment Tools ◽

Life Assessment ◽

Surgical Ligation ◽

Treatment Techniques ◽

Meta Analyses ◽

Q Statistic

Purpose Lower limb varicose veins have a significant effect upon the quality of life and a considerable socioeconomic impact despite their relatively benign nature. The aim of this study is to compare the effects of various therapeutic strategies among patients with varicose veins to surgical ligation and vein stripping on the basis of quality of life. Methods PubMed/Medline and Scopus databases were systemically searched from 1 January 2000 until 23 December 2015 for studies reporting outcome on the quality of life of different treatment techniques for varicose veins. We used Cohen’s d to make the outcomes of the reported scales comparable. Heterogeneity was calculated with the use of the Q statistic and the I2. Results A total of 1047 participants were randomized across all analyzed trials. The number of participants in a single trial ranged from 30 to 308. The majority of participants in any trial were C2 on the CEAP scores. Overall, the quality of evidence was low. For the meta-analysis performed at 12 months postintervention (seven studies, n = 1047 patients) and after random effects meta-analyses due to high heterogeneity, no differences are observed between intervention and surgical ligation and vein stripping. The pooled estimate is −0.001 and the 95% confidence interval is −0.069 to 0.067 with a p = 0.98. In the case of the 24 months, postintervention analysis (six studies, n = 840 patients) the inference is almost identical. The effect of various interventional modes of treatment compared to surgical ligation and vein stripping is negligible in terms of clinical outcomes and quality of life so that surgical ligation and vein stripping versus the other interventional procedures were equally effective approaches to treat great saphenous vein incompetence in terms of quality of life measurements. Conclusion The procedures were at least equally efficient in treating patients with varicose vein disease in terms of quality of life assessment tools at 12 and 24 months compared to surgical ligation and vein stripping.

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