Endovenous ablation with concomitant phlebectomy is a safe and effective method of treatment for symptomatic patients with axial reflux and large incompetent tributaries

Harlander-Locke, Michael P.; Jiménez, Juan Carlos; Lawrence, Peter F.; DeRubertis, Brian G.; Rigberg, David A.; Gelabert, Hugh A.

doi:10.1016/j.jvs.2012.12.054

Cited by 56 publications

(45 citation statements)

References 24 publications

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“…Es controversial la flebectomía de venas tributarias varicosas concomitante en el mismo acto quirúrgico con la obliteración de la vena safena insuficiente o diferida 18 . Existen argumentos que avalan la cirugía simultánea que evita una segunda intervención 19 , aunque se ha publicado que una vez realizada la obliteración del tronco safeno, menos de la mitad de los pacientes vuelve a realizarse una flebectomía 20 . En esta casuística preferimos efectuar estos procedimientos en una sola intervención, tomando en cuenta la idiosincrasia de nuestros pacientes, que solicitan terminar el problema en un solo tiempo quirúrgico, sin tener que volver a completar la extracción de las colaterales varicosas después, pues todos nuestros pacientes presentaron gruesas venas tributarias dilatadas sintomáticas.…”

Section: Comentariounclassified

Resultados en el corto y mediano plazo del tratamiento con radiofrecuencia de la insuficiencia venosa superficial

et al. 2018

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Objective: To evaluate short and midterm results after endovenous radiofrequency obliteration for treatment of saphenous reflux. Material and Method: Review and updated follow-up of a clinical series of patients after endovenous radiofrequency obliteration of insufficient saphenous trunks at the Hospital Dr. Eduardo Pereira, Valparaíso. Diagnosis was based on clinical parameters and color doppler ultrasonography. A preoperative and postoperative quality of life questionnaire was executed. Results: 77 patients (57 female) with an average age 58.3 years (23-83) and a mean follow-up time of 13.6 months. Patients consulted for symptomatic primary varicose veins of one lower extremity (49) or both (28) with 105 extremities. According to CEAP classification there were C2:84, C3:1, C4:9, C5:4 and C6:7. There were no C0 or C1 extremities. Superficial tributaries of more than 3 mm diameter were removed using Muller's method in all extremities. Furthermore, in some patients procedures were performed as complementary treatments: perforating veins ligation, skin grafting of ulcers or cutaneous-aponeurotic resection and deferred skin graft. A color doppler ultrasonography was performed one month later observing proper saphenous vein obliteration in 99% of cases and 94% at 6-months follow-up. There were no signs of deep vein thrombosis in all patients. The quality of life questionnaire revealed symptomatic relief and surgical satisfaction in the majority of patients. Conclusion: Endovascular radiofrequency obliteration for treatment of saphenous reflux is an effective method for the short and mid terms and can be done alongside other procedure. Key words: radiofrecuency; saphenous vein. ResumenObjetivo: Evaluar los resultados iniciales y en el mediano plazo del tratamiento con radiofrecuencia (RF) de la Insuficiencia Venosa Superficial (IVS) de las extremidades inferiores. Material y Método: Serie de pacientes operados en el Hospital Dr. Eduardo Pereira, Valparaíso por IVS con tratamiento de los troncos safenos insuficientes mediante ablación RF. El diagnóstico fue clínico y mediante eco-doppler color. Se efectuó un cuestionario de calidad de vida en el pre y posoperatorio. Resultados: 77 pacientes (57 mujeres), edad promedio de 58,3 años (23-83) y un seguimiento promedio de 13,6 meses. Los pacientes consultaron por várices primarias sintomáticas de una extremidad inferior (49) o ambas (28) con 105 extremidades, clasificación CEAP C2:84, C3:1, C4:9, C5:4, y C6:7. No hubo extremidades C0 o C1. Se agregó extirpación de tributarias varicosas superficiales mayores de 3 mm de diámetro con gancho en todas las extremidades. Además, en algunos pacientes se realizó ligadura directa de venas perforantes, injerto de úlceras, o resección cutáneo-aponeurótica e injerto diferido como tratamientos complementarios. Se realizó controles con eco-doppler color observando una correcta ablación ecográfica de la vena safena en un 99% a un mes y 94% a los 6 meses de seguimiento. Hubo ausencia de trombosis venosa profunda en todos los pacientes. El ...

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Section: Comentariounclassified

Resultados en el corto y mediano plazo del tratamiento con radiofrecuencia de la insuficiencia venosa superficial

et al. 2018

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“…Concomitant treatment of varicosities is associated with optimal improvement in both clinical disease severity and quality of life. 19,20 Superficial and Deep Venous Insufficiency It is not rare to see patients with both superficial and deep venous insufficiency. The most common cause is the valve insufficiency of the deep veins due to DVT; in rare conditions it can be due to congenital valve or vessel abnormalities.…”

Section: Ambulatory Phlebectomymentioning

confidence: 99%

“…Venous reflux increases the risk of developing varicose veins, especially in cases of combined deep and superficial reflux. 19 An incompetent vessel due to venous refluxing is itself unnecessary and useless because it is carrying venous blood in a retrograde direction and causes symptoms. Graduated compression has been proven useful in managing venous insufficiency.…”

Section: Ambulatory Phlebectomymentioning

confidence: 99%

“…External valvuloplasty, such as external vein valve wrapping, is a reconstructive surgical modality preferred in cases with dilation and reflux due to valve incompetency. 19 It aims to increase the coating surface and restore valve competency by external support 22 and has not gained large popularity due to its efficacy. However, some experts recommend external valvuloplasty for venous refluxing because it can be at least comparable to or probably better than conventional ligation and stripping.…”

Section: Ambulatory Phlebectomymentioning

confidence: 99%

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The Management of Varicose Veins

Lin

Zhang

Sun

et al. 2015

International Surgery

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This study aimed to review the current management modalities for varicose veins. There are a variety of management modalities for varicose veins. The outcomes of the treatment of varicose veins are different. The papers on the management of varicose veins were reviewed and the postoperative complications and efficacy were compared. Foam sclerotherapy and radiofrequency ablation were associated with less pain and faster recovery than endovenous laser ablation and surgical stripping. Patients undergoing endovenous laser ablation and radiofrequency ablation are most likely to have a faster recovery time and earlier return to work in comparison with those undergoing conventional high ligation and stripping. A randomized controlled study in multiple centers is warranted to verify which approach is better than others for the treatment of varicose veins. V aricose veins are dilated branches of the great saphenous vein and small saphenous vein; the incidence of varicose veins varies from 10% to 30%.

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“…The problem normally presents as a finding on posttreatment duplex scans and can resolve without any anticoagulation treatment. A four-level classification system and management strategies have been suggested for EHIT 28,29. Patients with complete occlusion of the deep vein by EHIT should be treated with anticoagulation while partial occlusion may be left to the clinician’s discretion, although debate continues on the matter.…”

Section: Findings From Literature Searchmentioning

confidence: 99%

Clinical utility of the Covidien Closure Fast™ Endovenous Radiofrequency Ablation Catheter

Braithwaite¹,

Braithwaite²

2014

MDER

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The Closure Fast™ Endovenous Radiofrequency Ablation Catheter is the latest version of a minimally invasive system for the treatment of patients with superficial venous disease. The Closure Fast™ catheter heats the vein wall to 120°C, causing denaturation of the collagen of the vein wall and contraction of the vessel such that no blood can flow through it. Nearly one million systems have been sold since the product was launched. Many, if not all, patients can be treated under local anesthesia with the Closure Fast™ catheter. Duplex ultrasound reports occlusion rates for the treated vein of 94%–98% at 1 year and 85%–93% at 3 years. The system produces average postoperative pain scores of less than 2 out of 10 on a visual analog score. In the first postoperative week, 76% of patients do not require analgesia. Some 45% of patients return to normal activity on the first postoperative day. Serious complications appear to be rare following the Closure Fast™ procedure. Transient paresthesia occurs in 0.2% of cases, thrombophlebitis in 1%–10%, and thromboembolic events in up to 1.4%, mainly heat-induced thrombosis. Closure Fast™ adds significant costs to treating superficial venous disease but studies have shown it to be cost-effective when used in an office setting.

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Endovenous ablation with concomitant phlebectomy is a safe and effective method of treatment for symptomatic patients with axial reflux and large incompetent tributaries

Cited by 56 publications

References 24 publications

Resultados en el corto y mediano plazo del tratamiento con radiofrecuencia de la insuficiencia venosa superficial

Resultados en el corto y mediano plazo del tratamiento con radiofrecuencia de la insuficiencia venosa superficial

The Management of Varicose Veins

Clinical utility of the Covidien Closure Fast™ Endovenous Radiofrequency Ablation Catheter

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Endovenous ablation with concomitant phlebectomy is a safe and effective method of treatment for symptomatic patients with axial reflux and large incompetent tributaries

Cited by 56 publications

References 24 publications

Resultados en el corto y mediano plazo del tratamiento con radiofrecuencia de la insuficiencia venosa superficial

Resultados en el corto y mediano plazo del tratamiento con radiofrecuencia de la insuficiencia venosa superficial

The Management of Varicose Veins

Clinical utility of the Covidien Closure Fast&trade; Endovenous Radiofrequency Ablation Catheter

Contact Info

Product

Resources

About

Clinical utility of the Covidien Closure Fast™ Endovenous Radiofrequency Ablation Catheter