Histopathological findings of the human great saphenous vein treated with endoluminal radio frequency ablation

Bedi, Harinder Singh; Calton, Nalini; Kwatra, Kanwardeep Singh; Tewarson, Vivek

doi:10.5455/2349-2902.isj20140502

Cited by 3 publications

(1 citation statement)

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“…Macroscopic and microscopic features reported here inside and around the vein after HIFU treatment have also been observed following thermoablation procedures like RFA or laser: primary changes after radiofrequency and laser treatments include vein shrinkage, vein induration, medial and adventitial lesions, vein thrombosis and perivenous tissue damages [36][37][38][48][49][50][51][52][53][54][55][56]. Tissue repair response has also been reported in RF or laser chronic studies and were characterized by gradual replacement of injured tissue components by granulation and fibrous connective tissue [35,49,57,58].…”

Section: Discussionsupporting

confidence: 60%

Efficacy and safety assessment of an ultrasound-based thermal treatment of varicose veins in a sheep model

Barnat

Grisey

Gerold

et al. 2020

International Journal of Hyperthermia

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Purpose: Varicose veins are a common pathology that can be treated by endovenous thermal procedures like radiofrequency ablation (RFA). Such catheter-based techniques consist in raising the temperature of the vein wall to 70 to 120 C to induce vein wall coagulation. Although effective, this treatment option is not suited for all types of veins and can be technically challenging. Materials and methods: In this study, we used High-Intensity Focused Ultrasound (HIFU) as a noninvasive thermal ablation procedure to treat varicose veins and we assessed the long-term efficacy and safety of the procedure in a sheep model. In vivo experiments were first conducted on two saphenous veins to measure the temperature rise induced at the vein wall during HIFU ablation and were compared with reported RFA-induced thermal rise. Thermocouples were inserted in situ to perform 20 measurements during 8-s ultrasound pulses at 3 MHz. Eighteen saphenous veins of nine anesthetized sheep (2-2.5 % Isoflurane) were then exposed to similar pulses (85 W acoustic, 8 s). After treatments, animals recovered from anesthesia and were followed up 30, 60 and 90 days post-treatment (n ¼ 3 animals per group). At the end of the follow-up, vein segments and perivenous tissues were harvested and histologically examined. Results: Temperatures induced by HIFU pulses were found to be comparable to reported RFA treatments. Likewise, histological findings were similar to the ones reported after RFA and laser-based coagulation necrosis of the vein wall, thrombotic occlusions and vein wall fibrosis. Conclusion: These results support strongly the effectiveness and safety of HIFU for ablating non-invasively veins.

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