A randomized clinical trial of the effects of saphenous and perforating veins radiofrequency ablation on venous ulcer healing (VUERT trial)

Puggina, Juliana; Sincos, Igor Rafael; Campos, Walter; Porta, Rina Maria Pereira; Santos, Jorgete Barreto dos; Luccia, Nélson De; Puech-Leão, Pedro; Collares, F.; Silva, Erasmo Simão da

doi:10.1177/0268355520951697

Cited by 11 publications

(3 citation statements)

References 29 publications

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“…The results of their study showed venous ulcer healing rates had been higher in patients whom received endovenous radiofrequency ablation and two-layer compression bandages when compared with patients whom only received compression bandages alone. Similar results were achieved recently in VUERT Trial 23 with combination of radiofrequency ablation and compression bandages in means of not only venous ulcer treatment but also prevention of recurrences. In addition, the efficacy of cyanoacrylate glue ablation 24 and mechanochemical ablation methods 25 has also been presented in the literature.…”

Section: Discussionsupporting

confidence: 87%

Efficiency of endovenous laser and glue ablation methods in comparison with conventional surgery for the treatment of venous ulcers

Erdinç

2022

Phlebology

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Introduction In this study, we aimed to investigate the efficiency of endovenous laser and glue ablation techniques and compared the results with conventional surgical stripping. Patients and Methods Between January 2005 and January 2020, among 3133 consecutive patients with superficial venous reflux disease receiving treatment at our institution, there were 112 consecutive patients with active venous ulcers. Patients were divided into 3 groups as receiving conventional open surgical treatment (Group 1, n: 70), endovenous glue ablation (Group 2, n: 20), and endovenous laser ablation (Group 3, n: 22). Comorbidity factors, duration and size of the ulcers, deep, perforating, and small saphenous vein disease detected with detailed Doppler ultrasonography, and duration for healing and recurrence were investigated. Results The age, gender, comorbidities, smoking, history of previous treatment, diameter of the small saphenous vein, number of refluxing perforating veins, size of the ulcer, and ulcer recurrence ratio were not significantly different between groups. There were 7 patients with bilateral disease and in total 119 legs were intervened. Mean durations for complete ulcer healing were significantly lower in Group 1 (53.28 ± 22.1 days) than Group 2 (73.7 ± 39.6 days); however, it did not differ significantly between Group 1 and Group 3 (62.59 ± 19.65 days), and Group 2 and Group 3 ( p: 0.26). Ulcers recurred in 23 patients (33%) in stripping group at a mean follow up of 14.42 ± 4.6 months, in 7 patients (35%) in glue ablation group at a mean follow up of 11.97 ± 2.94 months, and in 5 patients (23%) in laser ablation group at a mean follow up of 12.66 ± 3.48 months ( p > 0.05 for all). Increased body mass index, co-existence of chronic venous insufficiency, active cigarette smoking, non-compliance with physician advises and exercise and compression stockings, and depth of the ulcers were correlated with recurrence. Conclusion The rationelle beyond treatment of the venous ulcers and prevention of recurrence relies on relief of the venous hypertension by interventional methods and/or compression therapy. None of the methods is superior over the others. Healing in short term without further recurrence may be achieved with successful intervention as well as good patient compliance.

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Section: Discussionsupporting

confidence: 87%

Efficiency of endovenous laser and glue ablation methods in comparison with conventional surgery for the treatment of venous ulcers

Erdinç

2022

Phlebology

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“…Currently, there is no clear consensus on how many times a patient with a VLU should visit a vascular outpatient J o u r n a l P r e -p r o o f 10 clinic. Based on other studies, most vascular clinics seem to prefer a single-treatment approach 14,15 . However, other studies support that patients with VLUs should be controlled and treated with further endovenous ablation when necessary.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with delayed venous ulcer healing after endovenous intervention for superficial venous insufficiency

Pihlaja

Vanttila²,

Ohtonen³

et al. 2022

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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“…Die schon zitierte Serie von Lawrence et al [15] beschreibt ausschließlich PV mit hartnäckigen Ulzerationen und kommt zu dem Schluss, dass kein Ulkus ohne den erfolgreichen Verschluss zumindest einer inkompetenten Perforansvene zur Abheilung gelangte. In der VUERT-Studie konnte in 56 Fällen ein statistisch rascheres Abheilen der Ulzerationen nach erfolgreicher endovenöser Therapie der PV festgestellt werden (p < 0,05) [18].…”

Section: Diskussionunclassified

Erste Erfahrungen mit einem neuen Radiofrequenzsystem zur endovenösen Perforanstherapie

Eisele

Kirsch²

2022

Phlebologie

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Zusammenfassung Einführung Die Behandlung der Perforantenvarikose (PV) gehört zu den großen Herausforderungen in der Phlebologie – nicht nur aufgrund der Vergesellschaftung mit chronischen Ulzera crurium und der Rezidivrate. Endovenöse Verfahren der Perforantenablation (EPA) unterliegen technischen Schwierigkeiten. Wir berichten von einer ersten Serie der EPA mit einem neuartigen Radiowellensystem. Material, Patienten und Methoden Ausschließlich isolierte PV wurden in die Studie aufgenommen. Zur Diagnosestellung wurden dopplersonografische Untersuchungen (DU) durchgeführt. Die ultraschallgeführte EPA erfolgt unter sterilen Kautelen in der ambulanten Operationsabteilung. Postinterventionelle DU wurden nach einem Tag und 14 Tagen, 5 Wochen sowie 3, 6 und 12 Monaten terminiert. Im Falle einer Rekanalisierung wurde eine Schaumsklerosierung angestrebt. Ergebnisse Neun PV wurden behandelt. Der durchschnittliche Energieeintrag betrug 969J. Nach einem medianen Nachuntersuchungszeitraum von 257 Tagen betrug die primäre Verschlussrate 75%, die sekundäre nach Schaumsklerosierung 89%. Die minimale Komplikationsrate trug zu einer hohen Patientenakzeptanz bei. Schlussfolgerung Die EPA zur Behandlung der PV mit dem neuen Radiowellensystem hat sich als wirksam und verträglich bewährt. Weiteren Untersuchungen wird es vorbehalten sein, die endgültige Rolle der EPA in der Behandlung von PV zu definieren.

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A randomized clinical trial of the effects of saphenous and perforating veins radiofrequency ablation on venous ulcer healing (VUERT trial)

Cited by 11 publications

References 29 publications

Efficiency of endovenous laser and glue ablation methods in comparison with conventional surgery for the treatment of venous ulcers

Efficiency of endovenous laser and glue ablation methods in comparison with conventional surgery for the treatment of venous ulcers

Factors associated with delayed venous ulcer healing after endovenous intervention for superficial venous insufficiency

Erste Erfahrungen mit einem neuen Radiofrequenzsystem zur endovenösen Perforanstherapie

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