A systematic review supporting the Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society guidelines on the management of varicose veins

Farah, Magdoleen H.; Nayfeh, Tarek; Urtecho, Meritxell; Hasan, Bashar; Amin, Mustapha; Sen, Indrani; Wang, Zhen; Prokop, Larry J.; Lawrence, Peter F.; Gloviczki, Péter; Murad, M. Hassan

doi:10.1016/j.jvsv.2021.08.011

Cited by 48 publications

(28 citation statements)

References 111 publications

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“…A subsequent study did not find any differences either, in terms of recurrences, between standard surgery and endovenous treatment (laser or radiofrequency), although the causes of the relapses are different [14]. Finally, a recent systematic review, endorsed by three major vascular societies, confirms that the high ligation of the saphenous and stripping record similar rates of long-term closure as the latest surgical techniques [15].…”

Section: Discussionmentioning

confidence: 93%

Endoglin and Other Angiogenesis Markers on Recurrent Varicose Veins

Sánchez¹,

Martínez²,

García³

et al. 2022

Preprint

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Background: Surgery on varicose veins (crossectomy and stripping) leads to recurrence and has clinical and socio-economic repercussions. Their etiopathogenesis has yet to fully under-stood. Objective: Study the expression of endoglin and other molecules involved in the neovascu-larisation process in patients suffering from this disease. Methods: 43 patients that have undergone surgery for varicose veins (24 primary and 19 recurrent). They were identified on the venous wall (proximal -saphenofemoral junction- and distal), via real-time RT-PCR, and in serum, via ELISA: Endoglin (Eng), Vascular Endothelial Growth Factor (VEGF-A), its receptors 1 and 2 (VEGFR1 or FLT1), (VEGFR2 or FLK), and the Hypoxia-Inducible Factor (HIF-1A). All the patients signed a con-sent form. Results: The recurrent group recorded a higher expression of Eng, VEGF-A, VEGFR1 and VEGFR2 at the level of proximal venous wall compared to the primary group. HIF-1A did not record any differences. As regards the determination of the distal venous wall, no markers recorded differ-ences between the groups. Among the serum determinations, only sFLT1 recorded a significant drop among the patients with recurrent varicose veins. Conclusions: Patients with recurrent vari-cose veins record a higher expression of endoglin and other markers of angiogenesis in proximal veins. Endoglin in the blood (sEng) has not proven to be of any use in recurrent varicose veins.

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Section: Discussionmentioning

confidence: 93%

Endoglin and Other Angiogenesis Markers on Recurrent Varicose Veins

Sánchez¹,

Martínez²,

García³

et al. 2022

Preprint

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“…Specifically, following general or lumbar anesthesia, an incision is made at the groin or upper calf, the GSV is located and incised, the proximal end is ligated below the SFJ, a stripping wire with a probe is put into the GSV and advanced distally, and the proximal part of the GSV is tied to the wire and stripped. Recently, a growing number of research data do not consistently favor surgery as the standard treatment option due to postoperative complications, and the 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy[ 8 , 16 - 18 ].…”

Section: Surgical Therapymentioning

confidence: 99%

Section: Surgical Therapymentioning

confidence: 99%

“…The surgical outcome of HL/S is relatively satisfactory; HL/S is associated with higher anatomic closure rates at 30 d and 5 years than RFA and ultrasound-guided foam sclerotherapy (UGFS)[ 8 , 16 ]. HL/S has similar long-term saphenous vein closure rates with EVLA at 5 years[ 8 , 16 - 18 ]. However, the postoperative complications are DVT, bleeding, hematoma, ecchymosis, wound infection, nerve injury, pain, and delayed return to normal activity.…”

Section: Surgical Therapymentioning

confidence: 99%

“…Two-year occlusion rates were 93.7, 90.9, and 91.5% for NBCA, RFA, and EVLA, respectively[ 58 ]. CAE had higher anatomic closure rates at 30 d than EVLA[ 16 ]. Patients treated with CAE had less postoperative ecchymosis than those with RFA ( P < 0.01).…”

Section: Caementioning

confidence: 99%

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Strategies and challenges in treatment of varicose veins and venous insufficiency

Gao¹,

Qian²,

Wang³

et al. 2022

WJCC

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Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences. In the recent decade, the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular techniques. The literature was systematically searched on Medline without language restrictions. All papers on the treatment of varicose veins and venous insufficiency with different procedures were included and reviewed. Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) both are same safe and effective in terms of occlusion rate, and time to return to normal activity. In comparison with RFA or EVLT, Cure conservatrice et Hemodynamique de l'Insufficience Veineuse en Ambulatoire (CHIVA) may cause more bruising and make little or no difference to rates of limb infection, superficial vein thrombosis, nerve injury, or hematoma. In terms of recurrence of varicose veins, there is little or no difference between CHIVA and stripping, RFA, or EVLT. Great saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy (FS) group (51%) during 1 year of follow-up. The 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy. Although the mechanochemical endovenous ablation (MOCA) is a non-thermal, non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage, the overall success rate of MOCA is lower than those of other procedures such as EVLA, RFA, or high ligation and stripping. EVLA is the most cost-effective therapeutic option, with RFA being a close second for the treatment of patients with varicose veins. Endovenous thermal ablation (EVLA or RFA) is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose veins. Ultrasound-guided FS is associated with a high recurrence rate and can be used in conjunction with other procedures. MOCA and cyanoacrylate embolization appear promising, but evidence of their effectiveness is required.

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Endovenous Ablation Techniques

Kontothanassis

2024

Mastering Endovascular Techniques

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A systematic review supporting the Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society guidelines on the management of varicose veins

Cited by 48 publications

References 111 publications

Endoglin and Other Angiogenesis Markers on Recurrent Varicose Veins

Endoglin and Other Angiogenesis Markers on Recurrent Varicose Veins

Strategies and challenges in treatment of varicose veins and venous insufficiency

Endovenous Ablation Techniques

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