Ambulatory Varicosity avUlsion Later or Synchronized (AVULS): A Randomized Clinical Trial

Abstract

Mini AbstractA randomised clinical trial comparing simultaneous endovenous ablation and phlebectomy with endovenous ablation and delayed phlebectomy successfully recruited and treated 101 patients. Combined endovenous ablation and phlebectomy delivers improved clinical outcomes and a reduced rate of need for further procedures, in addition to early Quality of Life improvements. MethodsPatients undergoing local anaesthetic endovenous thermal ablation were randomised to either simultaneous phlebectomy or delayed varicosity treatment. Patients were reviewed at 6 weeks, 6 months and 1 year with clinical and quality of life scores completed, and were assessed at 6 weeks for need for further varicosity intervention, which was completed with either ultrasound guided foam sclerotherapy or local anaesthetic phlebectomy. Duplex ultrasound assessment of the treated trunk was completed at 6 months. ConclusionCombined endovenous ablation and phlebectomy delivers improved clinical outcomes and a reduced need for further procedures, as well as early quality of life improvements.

A multi-centre randomised controlled trial comparing radiofrequency and mechanical occlusion chemically assisted ablation of varicose veins – Final results of the Venefit versus Clarivein for varicose veins trial

“…If required (if symptomatic visible varicosities) and with patient consent, concomitant phlebectomies were then performed using standard Oesch hook technique with local tumescent anaesthesia. 12,13 All patients received a single prophylactic dose of low molecular weight heparin at the completion of the procedure. Use of prophylactic antibiotics was left to the discretion of the treating surgeon.…”

A randomised controlled trial of neuromuscular stimulation in non-operative venous disease improves clinical and symptomatic status

“…This study demonstrated a clinically and statistically significant 4-point reduction in VCSS score in the group receiving 60 minutes of treatment a day, suggesting an improvement in clinical severity of CVD following treatment with NMES, in line with that seen in randomised clinical trials after surgical intervention. [44][45][46] There was also a significant 6.29 point improvement in the disease specific AVVQ score in group C, which is above the accepted minimum important difference of 5 points in AVVQ. The control group demonstrated a non-significant worsening of their AVVQ score.…”

Effect of Transluminal Injection of Foam Sclerotherapy Combined with Endovenous Thermal Ablation of Varicose Veins

“…A previous study reported that combined EVLA plus phlebectomy improved clinical outcomes and reduced the need for further procedures. 3 On the other hand, several investigators have also claimed that concomitant phlebectomy could be omitted because EVLA improved the symptoms. 4 Because of the use of conventional hooks, only superficial varicose veins near the incision site could be avulsed.…”