Hook phlebectomy versus transilluminated powered phlebectomy for varicose vein surgery: Early results

Scavee, V.; Lesceu, O; Theys, Serge; Jamart, Jacques; Louagie, Yves; Schoevaerdts, Jean-Claude

doi:10.1053/ejvs.2002.1908

Cited by 42 publications

(43 citation statements)

References 18 publications

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“…Overall, reported complications after TIPP have varied considerably and include ecchymosis and hematoma in 4.9% to 95%, paresthesias and nerve injury in 9.5% to 39%, skin perforation in 1.2% to 5%, superficial phlebitis in 2.4% to 13%, swelling in 5% to 17.5%, hyperpigmentation in 1.2% to 3.3%, residual or recurrent varicose veins in 9.1% to 21.2%, and DVT in Ͻ1%. 174,210 In a comparison between TIPP and stab phlebectomy, TIPP revealed a difference in the number of incisions 174 and in the speed of the procedure. 178,179 However, there was no difference in bruising, cellulitis, and numbness at 1 to 2 weeks; nerve injury, residual veins, cosmesis score, and overall satisfaction at 6 weeks; and cosmesis or recurrence at 6 and 12 months.…”

Section: Results Of Open Venous Surgerymentioning

confidence: 99%

“…165 The invagination technique using a silk thread was perfected by Van Der Stricht 166 and using the Myers stripper, without the acorn-shaped head, by Fullarton and Calvert, 167 while perforate invaginate (PIN) stripping was introduced by Oesch 168 and perfected in the United States by Goren and Yellin. 169 Varicose vein excision performed from multiple larger skin incisions 170,171 was also abandoned, and ambulatory hook phlebectomy 172,173 and powered phlebectomy [174][175][176] have been adopted.…”

Section: Open Venous Surgerymentioning

confidence: 99%

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The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Gloviczki

Comerota²,

Dalsing

et al. 2011

Journal of Vascular Surgery

1,211

899

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The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping of the saphenous vein to the level of the knee (GRADE 1B). We recommend phlebectomy or sclerotherapy to treat varicose tributaries (GRADE 1B) and suggest foam sclerotherapy as an option for the treatment of the incompetent saphenous vein (GRADE 2C). We recommend against selective treatment of perforating vein incompetence in patients with simple varicose veins (CEAP class C(2); GRADE 1B), but we suggest treatment of pathologic perforating veins (outward flow duration ≥500 ms, vein diameter ≥3.5 mm) located underneath healed or active ulcers (CEAP class C(5)-C(6); GRADE 2B). We suggest treatment of pelvic congestion syndrome and pelvic varices with coil embolization, plugs, or transcatheter sclerotherapy, used alone or together (GRADE 2B).

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Section: Results Of Open Venous Surgerymentioning

confidence: 99%

Section: Open Venous Surgerymentioning

confidence: 99%

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Gloviczki

Comerota²,

Dalsing

et al. 2011

Journal of Vascular Surgery

1,211

899

View full text Add to dashboard Cite

show abstract

“…A randomized prospective trial comparing stab phlebectomy with TIPP reported a signifi cantly lower number of incisions (5 ± 0.17 vs 29 ± 1.28) and shorter operating time (18 minutes) but a signifi cantly higher recurrence rate at 52 weeks with TIPP (21.2% vs 6.2%) and no signifi cant difference in complication rates, including cellulitis, nerve injury, and bruising [14]. Other studies confi rm a reduction in the number of incisions, but a longer operating time and higher complication rate with the use of TIPP [4,15,16].…”

Section: Effi Cacymentioning

confidence: 96%

“…There has been no signifi cant improvement in the complication rate with the use of TIPP compared with stab phlebectomy [14][15][16]. One study of 141 patients (188 limbs) did not detect any difference in postoperative pain, hyperpigmentation, cellulitis, and numbness [14].…”

Section: Complicationsmentioning

confidence: 99%

Treatment of varicose veins

Nael¹,

Rathbun

2009

Curr Treat Options Cardio Med

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Varicose veins (VVs) are the most common manifestation of chronic venous insufficiency, affecting 25% of women and 15% of men. Reticular veins and telangiectasias (spider veins) are found in more than 80% of the general population. VVs produce symptoms of pain, swelling, heaviness, fatigue, and pruritus and predispose patients to complications including bleeding, superficial thrombophlebitis, and ulcerations that interfere with activities of daily living and result in lost time from work. Current treatments for VVs include conservative measures, and when these are unsuccessful, more invasive surgical and endovenous interventions primarily aimed at reducing venous hypertension and preventing progression to chronic inflammation and ulcerations. Surgical procedures including saphenous vein stripping, ligation of the saphenofemoral junction, and ambulatory phlebectomy are effective in the treatment of VVs but are associated with a high complication rate and recovery time. Emerging endovenous therapies, including endovenous laser therapy, radiofrequency ablation, and endovenous foam sclerotherapy, have shown similar efficacy in the treatment of VVs compared with more invasive surgical procedures, with lower complication rates and less time lost from work.

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“…[36][37][38] It requires fewer incisions. Side-effects include bruising, cellulitis, nerve injury, residual veins, haematoma and seroma.…”

Section: Transilluminated Powered Phlebectomy (Tipp)mentioning

confidence: 99%

The Treatment of Varicose Veins

Subramonia

Lees

2007

annals

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Varicose veins are a common problem and cause disfigurement, disability and impairment in the quality of life (QoL). Over 40,000 operations are performed each year for varicose veins within the NHS in England and Wales. Conservative methods like compression bandaging for ulceration can also be expensive. Varicose veins are, therefore, of significant clinical and economic importance to the health service and also have a major socio-economic impact on society. The advent of endovenous ablation techniques has expanded the surgical options for patients requiring treatment. Materials and MethodsRelevant studies were identified via the MEDLINE, PREMEDLINE, EMBASE, PubMed, Cochrane Library and Science Citation Index using Boolean search terms from their commencement to 2005. Further studies were obtained from references, reviews, specialty journals, trial registries and the internet and by hand-searching. Abstracts were searched for studies reporting safety, efficacy, technique and outcomes with emphasis on comparative studies and large case series. The authors concentrated on evidence published in the last 10 years to achieve a balance between comprehensiveness and precision. Non-English articles were excluded unless a translation could be obtained. Conference abstracts and unpublished reports were excluded. ResultsDefinitive treatment of varicose veins aimed at abolishing sources of venous reflux and removing long refluxing segments and varicose reservoirs can be achieved by conventional surgery or by endovenous ablation techniques. Transilluminated powered phlebectomy and subfascial endoscopic perforator surgery are less commonly employed.The main outcome in the selected studies is the abolition of saphenous vein reflux. However, there is wide variation in the reporting of outcomes between studies. Elimination of varicosities, recanalisation after endovenous ablation, recurrence of reflux, re-appearance of varicose veins, symptomatic improvement and re-treatment rates are not reported in all studies. Varicosities evident at follow-up are not clearly differentiated into residual, recurrent or newly incompetent veins. Some studies are affected by significant follow-up loss.

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Hook phlebectomy versus transilluminated powered phlebectomy for varicose vein surgery: Early results

Cited by 42 publications

References 18 publications

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Treatment of varicose veins

The Treatment of Varicose Veins

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