scholarly journals Using radiofrequency ablation for the treatment of lower limb varicose veins

2020 ◽  
Vol 28 ◽  
pp. 82-91
Author(s):  
Nguyen Van Viet Thanh ◽  
Nguyen Hoai Nam
Keyword(s):  
Radiofrequency Ablation ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Lower Extremities ◽  
Endovascular Interventions ◽  
Medication Intervention ◽  
Superficial Venous Insufficiency

Lower limb chronic venous insufficiency is a commonly seen disease which accounted for 40.5% of people over the age of 50 years old with females having 4.25 higher prevalence compared with males [23]. The lesions could be observed in superficial, perforating, deep veins or all three venous systems in the lower extremities [2]. Superficial veins in particular could be classified in 3 groups: chronic venous insufficiency, varicose veins, and thrombophlebitis. The treatment options of lower limb chronic venous insufficiency in general and chronic venous insufficiency – varicose veins are grouped in two major categories: medication/intervention and surgery. Since 1980s-1990s, endovascular interventions for the treatment of superficial venous insufficiency – varicose veins were introduced and were the new advancement in the treatment of lower limb venous insufficiency disorders [3, 7, 11, 12, 16] .

scholarly journals Superficial venous insufficiency from the infernal to the endothermal

2014 ◽  
Vol 96 (1) ◽  
pp. 5-10 ◽  
Author(s):  
D Carradice
Keyword(s):  
Gold Standard ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Resource Limitation ◽  
Skin Damage ◽  
The Common ◽  
Modern Treatment ◽  
The Cost ◽  
Superficial Venous Insufficiency

This review presents the common diseases associated with superficial venous insufficiency of the leg. These include varicose veins, swelling, skin damage and ulceration. The benefits and rationale behind treatment are discussed, followed by the historical advances from ancient mortality and prayer to the modern endovenous revolution. Finally, an overview of modern treatment options will discuss the evidence supporting the gold standard of endothermal ablation and the cost effectiveness of treatment at this time of challenging resource limitation.

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.

scholarly journals Clinical, ultrasonographic and histological findings in varicose vein surgery

2018 ◽  
Vol 64 (8) ◽  
pp. 729-735
Author(s):  
Moacir de Mello Porciunculla ◽  
Dafne Braga Diamante Leiderman ◽  
Rodrigo Altenfeder ◽  
Celina Siqueira Barbosa Pereira ◽  
Alexandre Fioranelli ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Clinical Classification ◽  
Histopathological Changes

SUMMARY OBJECTIVE This study aims to correlate the demographic data, different clinical degrees of chronic venous insufficiency (CEAP), ultrasound findings of saphenofemoral junction (SFJ) reflux, and anatomopathological findings of the proximal segment of the great saphenous vein (GSV) extracted from patients with primary chronic venous insufficiency (CVI) submitted to stripping of the great saphenous vein for the treatment of lower limb varicose. METHOD This is a prospective study of 84 patients (110 limbs) who were submitted to the stripping of the great saphenous vein for the treatment of varicose veins of the lower limbs, who were evaluated for CEAP clinical classification, the presence of reflux at the SFJ with Doppler ultrasonography, and histopathological changes. We study the relationship between the histopathological findings of the proximal GSV withdrawal of patients with CVI with a normal GSV control group from cadavers. RESULTS The mean age of the patients was higher in the advanced CEAPS categories when comparing C2 (46,1 years) with C4 (55,7 years) and C5-6(66 years), as well as C3 patients (50,6 years) with C5-6 patients. The normal GSV wall thickness (mean 839,7 micrometers) was significantly lower than in the saphenous varicose vein (mean 1609,7 micrometers). The correlational analysis of reflux in SFJ with clinical classification or histopathological finding did not show statistically significant findings. CONCLUSIONS The greater the age, the greater the clinical severity of the patients. The GSV wall is thicker in patients with lower limb varicose veins, but those histopathological changes are not correlated with the disease’s clinical severity or reflux in the SFJ on a Doppler ultrasound.

scholarly journals Ultrasound-guided foam sclerotherapy for severe chronic venous insufficiency

2017 ◽  
Vol 44 (5) ◽  
pp. 511-520 ◽  
Author(s):  
Guilherme Camargo Gonçalves de-Abreu ◽  
Otacílio de Camargo Júnior ◽  
Márcia Fayad Marcondes de-Abreu ◽  
José Luís Braga de-Aquino
Keyword(s):  
Minimally Invasive ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Hypertension ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
New Techniques

ABSTRACT Chronic venous insufficiency is characterized by cutaneous alterations caused by venous hypertension; in severe forms, it progresses to lower limb ulcers. Lower limb varicose veins are the main cause of chronic venous insufficiency, and the classic treatment includes surgery and compressive therapy. Minimally invasive alternative treatments for varicose veins include new techniques such as venous thermal ablation using laser or radiofrequency. The use of different methods depends on clinical and anatomical factors. Ultrasound-guided foam sclerotherapy is the venous injection of sclerosing foam controlled by Doppler ultrasound. Sclerotherapy is very useful to treat varicose veins, and probably, is cheaper than other methods. However, until the present, it is the less studied method.

Mechanical Properties of Skin in Venous Lower Limb Syndrome

1986 ◽  
Vol 1 (1) ◽  
pp. 7-14 ◽  
Author(s):  
J.P. Kuiper ◽  
B.A. Jagtman ◽  
A.J.M. Brakkee
Keyword(s):  
Mechanical Properties ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Skin Elasticity ◽  
Venous Wall

The authors have investigated the theory of loss of skin elasticity in conditions of chronic venous insufficiency and have attempted to establish a possible link between the mechanical properties of the skin and the venous wall. They conclude that while diminished skin elasticity is found in conjunction with reticular varicose veins, there is no correlation with truncal varicocities. They suggest therefore that different aetiological factors are concerned in truncal and reticular varicose veins.

Prevalence and management of ovarian venous insufficiency in the presence of leg venous insufficiency

2007 ◽  
Vol 22 (1) ◽  
pp. 29-33 ◽  
Author(s):  
R Sutaria ◽  
A Subramanian ◽  
B Burns ◽  
H Hafez
Keyword(s):  
Lower Extremity ◽  
Lower Limb ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Vena Cava ◽  
Vascular Surgeon ◽  
Venous Surgery ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Superficial Venous Insufficiency

Objective: The correlation between ovarian venous insufficiency and lower limb venous insufficiency remains poorly understood. Clinically, incompetent ovarian veins in association with lower extremity varicose veins are suspected when leg varicose veins are found in atypical distributions. Such distributions include upper lateral or posterior thigh, on the buttocks, crossing the inguinal ligament, and also in the vulval or perineal regions. The aim of this study was to determine the prevalence of ovarian venous insufficiency in those with clinically suspicious varicose veins, and to assess the effectiveness of ovarian venous embolization/ligation in treating this condition. Methods: Between June 2001 and December 2004, 424 female patients with lower limb superficial venous insufficiency were seen by a single vascular surgeon. These patients were clinically assessed, and those with atypical varicose veins were investigated with venous duplex examination and magnetic resonance imaging (MRI) venography. Patients with proven ovarian venous insufficiency were offered venography with a view to embolization or laparoscopic ligation. Results: A total of seven patients were clinically suspected of having ovarian venous insufficiency, of which three had recurrent varicose veins (42.9%). Of these, six were confirmed on MRI venography with the left side being more affected than the right; one of them had an occluded vena cava, three were treated by embolization, and two had laparoscopic ligation. Discussion: The prevalence of clinically detectable ovarian venous insufficiency in association with lower extremity varicose veins is in the region of 1.65%. Compared with the estimated prevalence of incidental ovarian venous insufficiency of 10–47%, this suggests that only a minority of incompetent ovarian veins will present with clinically detectable lower limb venous insufficiency. In our opinion, patients with signs suggestive of ovarian venous insufficiency in association with lower limb venous insufficiency should have their ovarian insufficiency controlled prior to embarking on limb venous surgery.

scholarly journals THE RESULTS OF THE APPLICATION OF LOW-INVASIVE METHODS FOR TREATMENT OF VARICOSE DISEASE

2019 ◽  
Vol 85 (4) ◽  
pp. 83-87
Author(s):  
E.G. Cherkasheninov ◽  
A.S. Kalmykova
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Laser Coagulation ◽  
Venous Reflux ◽  
Surgical Interventions ◽  
Severity Of The Disease ◽  
Light Guides

From 2015 to 2019, we performed surgical treatment of 136 patients for varicose veins of the lower extremities, of whom 74 patients were operated on by endovenous laser coagulation, 62 patients were operated on by radiofrequency ablation. The international classification of chronic venous insufficiency (CEAP) was used to distribute patients according to the severity of the disease. The indication for minimally invasive techniques was the presence of vertical reflux along the major and/or minor saphenous vein in combination with horizontal venous reflux in 95 % of cases. To perform radiofrequency ablation, the VNUS ClosureFast technique was used, and to perform endovasal laser obliteration, the «Lika-Hirurg» apparatus generating a wavelength of 1470 nm and radial (circular) light guides. To assess the results and quality of treatment, all patients underwent examination by a doctor with USDG of the operated lower extremity 1, 6 and 12 months after the treatment. Patients completed the Chronic Venous Insufficiency Questionnaire (CIVIQ 20) before surgery and 6 months after treatment. In all 136 patients, pathological venous reflux was not observed. In 2 patients, 6 months after EVLK, when performing ultrasound control in the trunks of the great saphenous vein, segmental recanalization without pathological reflux was determined. The use of radiofrequency ablation and endovasal laser coagulation of veins in the treatment of varicose veins shows positive results, and in most cases better than in classical surgical interventions, which is primarily due to the low trauma. One of the factors is the short duration of the patient's stay in the clinic and its activation immediately after the operation, which allows maintaining the routine of daily life.

Superficial Venous Disease

2018 ◽  
pp. 287-298
Author(s):  
Ronald S. Winokur ◽  
Geraldine Abbey-Mensah ◽  
Neil M. Khilnani
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Duplex Ultrasound ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Ulcers ◽  
Patient Morbidity ◽  
And Performance ◽  
Superficial Venous Insufficiency

Superficial venous insufficiency (SVI) is an extremely common condition affecting up to 39% of Americans, which results in significant patient morbidity and high healthcare costs (up to $3 billion per year for treatment). In addition to patients with asymptomatic spider veins and painful varicose veins, over 2 million adults have advanced chronic venous disease (CVD), and at least 20,000 individuals develop new venous ulcers each year. Patients suffering from venous insufficiency can benefit greatly from office-based, minimally invasive treatments. Successful treatment depends on understanding of superficial venous anatomy and pathophysiology, how to conduct a targeted history and physical exam, and performance and interpretation of Duplex ultrasound (DUS), as well as knowledge and application of the available treatment options.

Obesity and lower limb venous disease – The epidemic of phlebesity

2016 ◽  
Vol 32 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Huw OB Davies ◽  
Matthew Popplewell ◽  
Rishi Singhal ◽  
Neil Smith ◽  
Andrew W Bradbury
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Disease ◽  
Obese Patients ◽  
Obese People ◽  
Vein Thrombosis ◽  
Deep Vein

Introduction Lower limb venous disease affects up to one half, and obesity up to one quarter, of the adult population. Many people are therefore affected by, and present to health services for the treatment of both conditions. This article reviews the available evidence of pathophysiological and clinical relationship between obesity and varicose veins, chronic venous insufficiency and ulceration and deep vein thrombosis. Methods A literature search of PubMed and Cochrane libraries was performed in accordance with PRISMA statement from 1946 to 2015, with further article identification from following cited references for articles examining the relationship between obesity and venous disease. Search terms included obesity, overweight, thrombosis, varicose veins, CEAP, chronic venous insufficiency, treatment, endovenous, endothermal, sclerotherapy, bariatric surgery and deep vein thrombosis. Results The proportion of the population suffering from lower limb venous disease and obesity is increasing. Obesity is an important risk factor for all types of lower limb venous disease, and obese patients with lower limb venous disease are more likely to be symptomatic as a result of their lower limb venous disease. The clinical diagnosis, investigation, imaging and treatment of lower limb venous disease in obese people present a number of challenges. The evidence base underpinning medical, surgical and endovenous management of lower limb venous disease in obese people is limited and such treatment may be associated with worse outcomes and increased risks when compared to patients with a normal body mass index. Conclusion Lower limb venous disease and obesity are both increasingly common. As such, phlebologists will be treating ever greater numbers of obese patients with lower limb venous disease, and clinicians in many other specialties are going to be treating a wide range of obesity-related health problems in people with or at risk of lower limb venous disease. Unfortunately, obese people have been specifically excluded from many, if not most, of the pivotal studies. As such, many basic questions remain unanswered and there is an urgent need for research in this challenging and increasingly prevalent patient group.

scholarly journals Clinical and instrumental associations of knee osteoarthrosis and pathology of the veins of the lower extremities

2021 ◽  
Vol 59 (2) ◽  
pp. 184-191
Author(s):  
E. V. Zubareva ◽  
M. G. Goncharova ◽  
D. M. Maksimov ◽  
O. M. Lesnyak
Keyword(s):  
Body Mass Index ◽  
Older Women ◽  
Body Mass ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Lower Extremities ◽  
Vascular Pathology ◽  
Middle Aged ◽  
Knee Oa

Knee osteoarthritis (OA) and varicose disease of the lower extremities (VD) are two diseases common in middle– aged and older women. Questions about whether their combination is accidental or natural and whether VD affects the course and severity of OA, remain unresolved.The aim of the study was to look for the possible association between knee OA and lower limb vein pathology on the basis of clinical and modern instrumental investigation sand to study the effect of the VD on the clinical manifestations and severity of knee OA.Materials and methods. A case-control study was conducted in 85 women 40–60 years old with knee OA diagnosed in accordance with the criteria of ACR (1986) and 50 women of the same age without signs of knee OA. Women of both groups were evaluated for complaints and objective examination with an emphasis on diseases of the joints and veins of the lower extremities, radiography of the knee joints, ultrasound duplex scanning of the veins of the lower extremities. The severity of OA was assessed by the Lequenne indices. The clinical assessment of venous pathology was carried out according to the CEAP classification.Results. Patients with knee OA more often than their peers without joint pathology have VD (43% vs 22%; p=0.015), signs of chronic venous insufficiency (28% vs 12%; p=0.03), as well as valve failure of several lower limb veins simultaneously (53% vs 20%; p=0.0004). After correction by body mass index, the association of knee OA with detected vascular pathology remained clinically and statistically significant. The presence of VD with moderate manifestations of chronic venous insufficiency, as well as ultrasound signs of venous pathology, was not associated with the clinical signs and course of knee OA.Conclusions. Knee OA in middle-aged and older women, regardless of body mass index, is associated with VD and ultrasound signs of simultaneous valves failure of several veins. Manifestations of chronic venous insufficiency did not affect the clinical picture and severity of knee OA.

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