scholarly journals Concomitant radiofrequency ablation and foam-sclerotherapy of varicose veins; a design with novel plots

2021 ◽  
Vol 1 (1) ◽  
pp. 18-23
Author(s):  
Hossein Hemmati ◽  
Kambiz Faridmarandi ◽  
Yousof Shahrouzvand ◽  
Sara Ramtinfar ◽  
Azadeh Mohammadi ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Varicose Veins ◽  
Foam Sclerotherapy

Acoustic reflectors are visible in the right heart during radiofrequency ablation of varicose veins

2014 ◽  
Vol 30 (8) ◽  
pp. 557-563 ◽  
Author(s):  
V Sounderajah ◽  
HM Moore ◽  
A Thapar ◽  
TRA Lane ◽  
K Fox ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Varicose Veins ◽  
Neurological Complications ◽  
Common Finding ◽  
Foam Sclerotherapy ◽  
Right Heart ◽  
Diagnostic Quality ◽  
Cardiac Septal Defects ◽  
Apical View ◽  
The Right

Objective Cerebrovascular events have been noted after foam sclerotherapy for varicose veins. One hypothesis is migration of microemboli to the brain through a cardiac septal defect. The aim of this study was to identify whether acoustic reflectors are found in the right side of the heart during radiofrequency ablation of varicose veins, as neurological events are not reported during these procedures. Methods Transthoracic echocardiography was performed during local anaesthetic radiofrequency ablation (VNUS ClosureFast) of the great saphenous vein in 14 patients. An apical view was captured at the start of the procedure, during each cycle of heating and at 1 min post-treatment. Patients were monitored for 1 h. Video loops were read by an independent cardiologist. The presence of acoustic reflectors was classified as: 0 = absent, 1 = occasional, 2 = stream, 3 = complete opacification. Results Loops were of diagnostic quality in 11/14 (79%) patients. After the second cycle of heating, acoustic reflectors moving through the right heart were seen in 5/11 (45%) patients. These were classified as grade 1 in four patients and grade 2 in one patient. No acoustic reflectors were seen in the left heart. No neurological symptoms were reported. Conclusion Acoustic reflectors in the right heart are a common finding during radiofrequency ablation of varicose veins. Considering the prevalence of cardiac septal defects (17%), more neurological events would be expected if these particles were indeed responsible for these events. Further work is required to elicit the mechanisms underlying neurological complications following sclerotherapy.

scholarly journals Comparison of microbubble presence in the right heart during mechanochemical and radiofrequency ablation for varicose veins

2016 ◽  
Vol 32 (6) ◽  
pp. 425-432 ◽  
Author(s):  
KH Moon ◽  
B Dharmarajah ◽  
R Bootun ◽  
CS Lim ◽  
TRA Lane ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Varicose Veins ◽  
Neurological Complications ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Right Heart ◽  
International Consensus ◽  
Mechanochemical Ablation ◽  
Significant Difference ◽  
The Right

Objective Mechanochemical ablation is a novel technique for ablation of varicose veins utilising a rotating catheter and liquid sclerosant. Mechanochemical ablation and radiofrequency ablation have no reported neurological side-effect but the rotating mechanism of mechanochemical ablation may produce microbubbles. Air emboli have been implicated as a cause of cerebrovascular events during ultrasound-guided foam sclerotherapy and microbubbles in the heart during ultrasound-guided foam sclerotherapy have been demonstrated. This study investigated the presence of microbubbles in the right heart during varicose vein ablation by mechanochemical abaltion and radiofrequency abaltion. Methods Patients undergoing great saphenous vein ablation by mechanochemical abaltion or radiofrequency ablation were recruited. During the ablative procedure, the presence of microbubbles was assessed using transthoracic echocardiogram. Offline blinded image quantification was performed using International Consensus Criteria grading guidelines. Results From 32 recruited patients, 28 data sets were analysed. Eleven underwent mechanochemical abaltion and 17 underwent radiofrequency abaltion. There were no neurological complications. In total, 39% (11/28) of patients had grade 1 or 2 microbubbles detected. Thirty-six percent (4/11) of mechanochemical abaltion patients and 29% (5/17) of radiofrequency ablation patients had microbubbles with no significant difference between the groups ( p=0.8065). Conclusion A comparable prevalence of microbubbles between mechanochemical abaltion and radiofrequency ablation both of which are lower than that previously reported for ultrasound-guided foam sclerotherapy suggests that mechanochemical abaltion may not confer the same risk of neurological events as ultrasound-guided foam sclerotherapy for treatment of varicose veins.

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