scholarly journals Endovenous cyanoacrylate ablation for chronic venous insufficiency and varicose veins among Asians

2021 ◽  
Vol 50 (3) ◽  
pp. 241-249
Author(s):  
Sally SJ Chan ◽  
Yiu Che Chan ◽  
Stewart R Walsh ◽  
Tze Tec Chong ◽  
Edward TC Choke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Current Evidence ◽  
Complication Rates ◽  
Venous Anatomy ◽  
Cyanoacrylate Glue ◽  
True Value

Introduction: Endovenous cyanoacrylate glue (CAG) ablation for the treatment of chronic venous insufficiency (CVI) and varicose veins has shown non-inferior outcomes with an excellent safety profile, high patient satisfaction rate, and excellent efficacy when compared to the gold standard of endothermal ablation. A review of the current literature for CAG use in CVI showed that most studies and longer-term data are from Caucasian-based populations, which are subject to different anatomical venous variations and socio-economical contexts. This review aimed to gather the current evidence for CAG use in Asian CVI patients. Methods: Asian studies for the use of CAG in CVI were included in this review. Successful ablation rates, quality of life improvement and novel complications such as glue hypersensitivity reactions are described, along with anatomical descriptions of superficial venous anatomy in study patients. Use of CAG in Singapore and Asia was addressed. Results: CAG has been gaining traction as an option for CVI treatment in Asians. In Singapore, it has been adopted with comparable low complication rates and significant improvement of quality of life after treatment. As we increase our understanding of the variations in venous anatomy in the Asian population, new techniques such as retrograde deployment of the device and use of CAG ablation for venous leg ulcers have been developed. Conclusion: Further robust evidence in terms of large randomised control trials along with costeffectiveness studies are needed to determine the true value of CAG ablation in the Asian setting.

scholarly journals Iliac venous stenting for outflow obstruction does not significantly change the quality of life of patients with severe chronic venous insufficiency

2019 ◽  
Vol 8 ◽  
pp. 204800401989096 ◽  
Author(s):  
Alexander Shiferson ◽  
Edouard Aboian ◽  
Michael Shih ◽  
Qinghua Pu ◽  
Theresa Jacob ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Life Questionnaire ◽  
Outflow Obstruction ◽  
Venous Stenting ◽  
True Value ◽  
The Impact ◽  
Stented Group

Purpose Percutaneous endovenous iliac stenting has emerged as a new modality in the treatment of advanced chronic venous insufficiency with outflow obstruction. However, the effect of this intervention on the quality of life remains unclear. We examined the impact of iliac venous stenting for outflow obstruction as compared to conservative medical management on the quality of life in severe chronic venous insufficiency patients. Methods Medical records of all patients with CEAP class 5 and 6 disease (N = 172) who underwent ilio-caval venography with intravascular ultrasonography (IVUS) at a single institution over a seven-year period, were reviewed for this case–control study. Quality of life evaluation was performed utilizing the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-20) one year after the index procedure. Results Of the 172 severe chronic venous insufficiency patients, 109 were stented and 63 patients were treated medically based on their venography and IVUS results. The indication for stenting was confirmation of IVUS determined surface area or diameter outflow stenosis of greater than 50% within the common or external iliac venous systems. Eighty patients (47%) responded with completed CIVIQ-20 questionnaires for analysis. Of these, 47 were from the stented group and 33 from the non-stented group. At least moderate persistent pain or discomfort post-procedure was reported by 20 (43%) stented group patients and 19 (58%) non-stented group patients. Scores for all the other criteria in the CIVIQ-20 were similar between the groups. The mean total CIVIQ-20 score was 45.23 and 47.13, respectively, in stented group and non-stented group patients. ( p = 0.678). Conclusion There was no significant difference in the quality of life reported by CEAP 5 and 6 patients who underwent iliac venous stenting versus those who were treated medically for presumed iliac outflow obstruction. Prospective studies are needed to determine the true value of iliac venous stenting based on IVUS criteria in the management advanced chronic venous insufficiency.

scholarly journals Ways to improve outpatient phlebological care with “one day” technology

2021 ◽  
Vol 18 (1) ◽  
pp. 30-39
Author(s):  
A. V. Pelevin ◽  
O. N. Guzhkov ◽  
D. L. Mushnikov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Health Sector ◽  
Laser Coagulation ◽  
Personalized Approach

Introduction. Chronic venous insufficiency is one of the most common diseases, so finding the best treatment options is one of the most urgent tasks of surgery. One of the methods of implementing this direction is to apply a personalized approach. The aim of the study is to improve surgical care for patients with VVPC by introducing a personalized approach.Materials and methods. The study was based on clinical observations and special studies in 428 patients with uBVNC in outpatient settings. All of those surveyed were women. The average age of the patients was 42.3 ± 15.5 years. All patients were operated on — endovasal laser coagulation (EVLk) was performed in the traditional way. Clinical examination of patients, as well as special methods of research was carried out. A questionnaire was used to assess the quality of life of patients. The peculiarity of the study was the use of social and hygienic methods: survey, psychological testing, expert. Statistical analysis and mathematical processing of results were carried out with the help of modern computer technologies based on the Statisticala 6 application package.Results. It has been established that over the past five years in the Ivanovo region there has been an increase in the incidence of vessels of the lower extremities. The frequency of varicose veins exceeds 47 per 100 patients examined. The desire to perform surgery in the nonstate health sector is observed in 9.8 cases. In 85.0% of patients with VBNC, received for surgical treatment, have a lack of preparedness. Their information, clinical and psychological level is 65.0–89.0% of the due and direct influence on the formation of an unfavorable result.Conclusion. Thus, the implementation of a personalized approach to the surgical treatment of patients with chronic venous insufficiency by laser coagulation provides on a par with the reliable obliteration of altered veins the fastest clinical recovery of patients, improvement of their quality of life, satisfaction with results, good hemodynamic and cosmetic effects.

Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

2019 ◽  
Vol 34 (8) ◽  
pp. 543-551 ◽  
Author(s):  
Tjun Y Tang ◽  
Harsha P Rathnaweera ◽  
Jia W Kam ◽  
Tze T Chong ◽  
Edward C Choke ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Asian Population ◽  
Closure System ◽  
Cyanoacrylate Glue ◽  
Catheter Technique

Objectives The aim of this prospective single-centre study is to assess the effectiveness and patient experience of the VenaSeal™ Closure System, a novel non-thermal, non-tumescent catheter technique, which uses cyanoacrylate glue to occlude the refluxing truncal superficial veins to treat varicose veins and chronic venous insufficiency, in a multi-ethnic Asian population from Singapore. Methods Seventy-seven patients (93 legs; 103 procedures) underwent VenaSeal™ Closure System ablation. Forty-nine (63.6%) for great saphenous vein incompetence, 16 (20.8%) bilateral great saphenous vein, 2 (2.6%) small saphenous vein and 10 (13.0%) combined unilateral great saphenous vein and small saphenous vein/anterior thigh vein reflux. In addition, 65/93 legs (69.9%) had C4–C6 disease. Patients were reviewed at 2 weeks, 3, 6 and 12 months post-procedure. Results There was 100% technical success. 28/77 (36.4%) underwent concomitant phlebectomies. All procedures were well tolerated with a mean post-operative pain score of 3.0 (range: 0–5). After three months, median patient satisfaction was 9.0 (interquartile range: 7.0–10.0). At two-week follow-up, the great saphenous vein was completely occluded in 88/88 (100%) veins and small saphenous vein completely closed in 11/11 (100%) veins. At three-month follow-up, the great saphenous vein was occluded in 51/53 (96.2%) veins and small saphenous vein completely closed in 5/5 (100%) veins. At six-month follow-up, the great saphenous vein was completely occluded in 42/45 (93.3%) veins and small saphenous vein completely closed in 5/7 (71.4%) veins. At one year, great saphenous vein and small saphenous vein occlusion rates were 54/59 (91.5%) and 5/8 (62.5%), respectively. There was one deep vein thrombosis. Transient superficial phlebitis was reported in 10/93 (10.8%) legs, which were all self-limiting. There were 9/103 (8.7%) anatomical recurrences, but no patients required re-intervention as they were asymptomatic. Conclusions Cyanoacrylate glue is a safe and efficacious modality to ablate refluxing saphenous veins in Asian patients in the short term. There is a high satisfaction rate and peri-procedural pain is low. Early results are promising but further evaluation and longer term follow-up are required.

Impact of Great Saphenous Vein Foam Sclerotherapy on Quality of Life and Photoplethysmography Findings in Chronic Venous Insufficiency

2020 ◽  
Vol 46 (3) ◽  
pp. 369-375
Author(s):  
Felipe Coelho Neto ◽  
Rodrigo Gomes de Oliveira ◽  
Fernando Thomazinho ◽  
Anna Paula Weinhardt Batista ◽  
Iruena Moraes Kessler
Keyword(s):  
Quality Of Life ◽  
Saphenous Vein ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Foam Sclerotherapy

Effects of isokinetic calf muscle exercise program on muscle strength and venous function in patients with chronic venous insufficiency

2017 ◽  
Vol 33 (4) ◽  
pp. 261-266 ◽  
Author(s):  
Sabriye Ercan ◽  
Cem Çetin ◽  
Turhan Yavuz ◽  
Hilmi M Demir ◽  
Yurdagül B Atalay
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Exercise Program ◽  
Return Time ◽  
Isokinetic Muscle Strength ◽  
Joint Range

Objective The aim of this study was to observe the change of the ankle joint range of motion, the muscle strength values measured with an isokinetic dynamometer, pain scores, quality of life scale, and venous return time in chronic venous insufficiency diagnosed patients by prospective follow-up after 12-week exercise program including isokinetic exercises. Methods The patient group of this study comprised 27 patients (23 female, 4 male) who were diagnosed with chronic venous insufficiency. An exercise program including isokinetic exercise for the calf muscle was given to patients three days per week for 12 weeks. At the end of 12 weeks, five of the patients left the study due to inadequate compliance with the exercise program. As a result, control data of 22 patients were included. Ankle joint range of active motion, isokinetic muscle strength, pain, quality of life, and photoplethysmography measurements were assessed before starting and after the exercise program. Results Evaluating changes of the starting and control data depending on time showed that all isokinetic muscle strength measurement parameters, range of motion, and overall quality of life values of patients improved. Venous return time values have also increased significantly ( p < 0.05). Conclusion In conclusion, increase in muscle strength has been provided with exercise therapy in patients with chronic venous insufficiency. It has been determined that the increase in muscle strength affected the venous pump and this ensured improvement in venous function and range of motion of the ankle. In addition, it has been detected that pain reduced and quality of life improved after the exercise program.

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