scholarly journals Incidence of Nerve Injury after Endovenous Thermal Ablation for Incompetent Great Saphenous Veins

2021 ◽  
Vol 32 (3) ◽  
pp. 337-341
Author(s):  
Junichi Utoh ◽  
Yoshiharu Tsukamoto
Keyword(s):  
Nerve Injury ◽  
Thermal Ablation ◽  
Saphenous Veins ◽  
Endovenous Thermal Ablation

American College of Phlebology Guidelines – Treatment of refluxing accessory saphenous veins

2016 ◽  
Vol 32 (7) ◽  
pp. 448-452 ◽  
Author(s):  
Kathleen Gibson ◽  
Neil Khilnani ◽  
Marlin Schul ◽  
Mark Meissner
Keyword(s):  
Systematic Review ◽  
Thermal Ablation ◽  
Clinical Impact ◽  
Review Of The Literature ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Saphenous Veins ◽  
Ablation Laser ◽  
Endovenous Thermal Ablation ◽  
Recommendation Grade

The American College of Phlebology Guidelines Committee performed a systematic review of the literature regarding the clinical impact and treatment of incompetent accessory saphenous veins. Using an accepted process for guideline developments, we developed a consensus opinion that patients with symptomatic incompetence of the accessory great saphenous veins (anterior and posterior accessory saphenous veins) be treated with endovenous thermal ablation (laser or radiofrequency) or ultrasound-guided foam sclerotherapy to eliminate symptomatology (Recommendation Grade 1C).

Lidocaine safety after saphenous vein tumescent anesthesia

2019 ◽  
Vol 34 (10) ◽  
pp. 683-689
Author(s):  
Thomas F Wright ◽  
Giulietta F Brunetti ◽  
Patrick Kennedy
Keyword(s):  
Plasma Concentration ◽  
Observational Study ◽  
Thermal Ablation ◽  
Ultrasound Guidance ◽  
Tumescent Anesthesia ◽  
Saphenous Veins ◽  
Plasma Lidocaine ◽  
Endovenous Thermal Ablation ◽  
Safe Dose ◽  
Over Time

Objectives For endovenous thermal ablation of the saphenous veins, tumescent lidocaine anesthesia is often used. Unfortunately, information is sparse on the pharmacokinetics of lidocaine absorption and its maximum safe dose. The aim of this study was to evaluate plasma concentration of lidocaine on 12 lead electrocardiograms (ECGs) and symptoms over time after the administration of tumescent lidocaine during endovenous thermal ablation procedures in healthy volunteers. Methods An observational study of symptoms, 12 lead ECGs, and serum lidocaine levels were obtained following the administration of either 15 mg/kg lidocaine or 35 mg/kg lidocaine in the perivenous saphenous space under ultrasound guidance. Blood was drawn at regular intervals in heparinized tubes and spun at 3000 r/min for 10 min. The plasma lidocaine levels were plotted vs. time for statistical comparisons. Results With the 35 mg/kg dose, four of 11 participants developed symptoms of lidocaine toxicity at 40 min, which resolved by 180 min. The 35 mg/kg dose resulted in a mean serum lidocaine peak of 2.55 µg/ml at 60 min. The 15 mg/kg dose did not result in any symptoms of lidocaine toxicity, and it resulted in a serum lidocaine plateau of 0.85 µg/ml at 180 min. No significant changes were seen on the 12-lead ECG after the administration of lidocaine at either dose. Conclusions The 15 mg/kg total lidocaine dose did not cause symptoms and appears to be a safe lidocaine dosage for tumescent anesthesia for saphenous endovenous thermal ablations. The 35 mg/kg lidocaine dose is associated with lidocaine toxicity. More study on the maximal safe dose of lidocaine for endovenous thermal ablations is needed.

scholarly journals Sole use of dexmedetomidine for sedation and analgesia in patients undergoing endovenous thermal ablation for incompetent saphenous veins

2019 ◽  
Vol 7 (22) ◽  
pp. 638-638 ◽  
Author(s):  
Jin Ho Hwang ◽  
Il Soo Chang ◽  
Sang Woo Park ◽  
Won-Kyoung Kwon ◽  
Jae Joon Hwang
Keyword(s):  
Thermal Ablation ◽  
Saphenous Veins ◽  
Endovenous Thermal Ablation ◽  
Sedation And Analgesia

Foam sclerotherapy of the great saphenous vein in association with pre-terminal saphenous junction ligation/division as an office-based procedure: 12-Month results

2017 ◽  
Vol 33 (5) ◽  
pp. 321-329
Author(s):  
Moro Leo ◽  
Ricci Stefano ◽  
Antonelli Incalzi Raffaele
Keyword(s):  
Saphenous Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
Stem Length ◽  
Foam Sclerotherapy ◽  
Vein Occlusion ◽  
Saphenous Veins ◽  
Endovenous Thermal Ablation ◽  
Occlusion Rate

Objective Ultrasound-guided foam sclerotherapy (UGFS) – one of the most frequently recommended methods for treating great saphenous vein incompetence – is easy and inexpensive. However, it achieves a lower occlusion rate compared to endovenous thermal ablation. The application of UGFS to pre-terminal great saphenous vein interruption, eliminating the saphenous stem wash out effect, enhances the short-term occlusion rate. This study explores the results of this technique at 12 months. Method Thirty great saphenous veins (28 patients) with junction incompetence, with calibres >6 mm and >30 cm reflux stem length were submitted to echo-guided pre-terminal great saphenous vein interruption and foam great saphenous vein occlusion. Participants were subjected to a 12-month post-operative review by ultrasound assessment of great saphenous vein occlusion and terminal stump stability. Comparisons were made between pre-operative and 12-month Validation of Venous Clinical Severity Score (VCSS), photopletismography, Aberdeen questionnaire and complications. Results After 12 months, 28/30 great saphenous veins remained occluded (93%). One complete and one partial recanalization did not require retreatment. Four saphenous stumps showed a reflux during Valsalva (one due to recanalization, one limited to the stump, two with reflux in the anterior accessory saphenous vein). VCSS improved from 3.33 ± 1.64 to 0.67 ± 1.21 ( p < 0.05). Aberdeen questionnaire scores decreased from 9.44 ± 6.18 to 2.47 ± 3.77 ( p < 0.05). For photopletismographic examination, the mean venous refilling time (normal value: > 25 s) improved from 17.94 ± 11.97 to 31.4 ± 11.99 ( p < 0.05). Conclusion Applying pre-terminal great saphenous vein interruption to UGFS of the saphenous stem achieved an occlusion rate at one year similar to that of endovenous thermal ablation. The procedure is simple, effective, office based, and may be used as a 10-min prolongation to a phlebectomy.

A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins

2021 ◽  
pp. 026835552110087
Author(s):  
Julong Guo ◽  
Fan Zhang ◽  
Jianming Guo ◽  
Lianrui Guo ◽  
Yongquan Gu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Thermal Ablation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Compression Stocking ◽  
Number Needed To Treat ◽  
Saphenous Veins ◽  
Significant Difference ◽  
Endovenous Thermal Ablation

Objectives The aim of this study was to systemically review and analyze the efficacy of cyanoacrylate ablation (CA) in comparison with endovenous thermal ablation (ETA) for the treatment of incompetent saphenous veins. Methods A systematic literature search was conducted using databases of Pubmed, Embase, and Cochrane Library from the times of their inception to April 2020. Studies were selected based on inclusion and exclusion criteria after assessing the risk of bias in comparative studies with Cochrane and rating quality of evidence with the GRADE methodology. The meta-analysis was carried out using the Review Manager 5.4 program to conduct homogeneity tests. Results One cohort study and three randomized controlled trials (RCT), including a total of 1457 participants were included in the meta-analysis. ETA included endovenous laser ablation (ELVA) and radiofrequency ablation (RFA) in the selected studies. Comparison between CA and a combination of EVLA and RFA or RFA alone were carried out in two of RCTs, while comparison between CA with EVLA was conducted in one RCT and the cohort study. There was no statistical difference in closure rates between CA and ETA after pooled analysis. Similar symptom alleviation observed between different groups. However, the CA group showed a lower ecchymosis rate than RFA and a significantly lower incidence of adverse events, such as ecchymosis, phlebitis and paresthesia, than EVLA. Compared with ETA, the patients received CA treatment exhibited lower pain scores in a shorter procedure duration without needing compression stocking, returned to normal life sooner, and had significantly better quality of care. There was no significant difference in the number needed to treat for additional therapy after three months of follow-up between groups. Conclusions This meta-analysis indicates that CA has better overall outcomes than ETA and offers superior clinical benefits in the treatment of incompetent saphenous veins.

Endovenous radiofrequency powered segmental thermal ablation (Closure FAST) of great saphenous veins

Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 69-71 ◽  
Author(s):  
T. M. Proebstle ◽  
Keyword(s):  
Side Effects ◽  
Thermal Ablation ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Duplex Ultrasound ◽  
Multicenter Trial ◽  
Saphenous Veins ◽  
Clinical Control ◽  
Prospective Multicenter Trial

Summary Background: Radiofrequency powered segmental thermal ablation Closure FAST has become a globally engaged technology for ablation of incompetent great saphenous veins (GSVs). Mid-term results of slowly resolving side effects are still not described. Methods: RSTA-treated GSVs (n = 295) were followed for 24 months in a prospective multicenter trial. Clinical control visits included flow and reflux analysis by duplex-ultrasound and assessment of treatment related side effects at all times. Results: 280 of 295 treated GSVs (94.9%) were available for 24 months follow-up. According to the method of Kaplan and Meier at 24 months after the intervention 98.6% of treated legs remained free of clinically relevant axial reflux. The average VCSS score improved from 3.9 ± 2.1 at screening to 0.7 ± 1.2 at 24 months follow-up (p < 0.0001). While only 41.1% of patients were free of pain before treatment, at 24 months 99.3% reported no pain and 96.4% did not experience pain during the 12 months before. At 24 months n=3 legs showed pigmentation along the inner thigh and one leg showed study-treatment related paresthesia. Conclusion: Radiofrequency powered segmental thermal ablation Closure FAST showed a very moderate side-effect profile in conjunction with a high and durable clinical success rate.

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