Laser ablation versus mechanochemical ablation in the treatment of primary varicose veins: A randomized clinical trial

Tawfik, Ahmed; Sorour, Waleed A; El-Laboudy, Medhat E

doi:10.1016/j.jvsv.2019.10.025

Cited by 26 publications

(33 citation statements)

References 26 publications

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“…Clinically, both EVLA and MOCA were highly efficacious in the treatment of SVI, thus showing a significant improvement in VCSS and patient symptoms as reflected in the improved generic and disease-specific quality of life of the patients. Multiple randomized trials have shown that symptomatic outcomes are comparable or even superior in MOCA to patients receiving EVLA or RFA, with increased speed of improvement in VCSS scores following MOCA [243][244][245][246][247]. Furthermore, it was observed that the procedural discomfort from MOCA was as low as or lower than EVLA and that the postprocedure pain from MOCA during the first week tended to be lower [243,247].…”

Section: Cyanoacrylate Embolization (Cae)mentioning

confidence: 99%

“…Furthermore, it was observed that the procedural discomfort from MOCA was as low as or lower than EVLA and that the post-procedure pain from MOCA during the first week tended to be lower [ 243 , 247 ]. MOCA patients also had lower rates of postoperative phlebitis and returned to work earlier than EVLA patients [ 245 ].…”

Section: Advances In Minimally Invasive Treatmentmentioning

confidence: 99%

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Management of Lower Extremity Pain from Chronic Venous Insufficiency: A Comprehensive Review

Orhurhu

Chu²,

Xie

et al. 2021

Cardiol Ther

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Purpose of Review: Chronic venous insufficiency is found to some extent in a large proportion of the world's population, especially in the elderly and obese. Despite its prevalence, little research has been pursued into this pathology when compared to similarly common conditions. Pain is often the presenting symptom of chronic venous insufficiency and has significant deleterious effects on quality of life. This manuscript will describe the development of pain in chronic venous insufficiency, and will also review both traditional methods of pain management and novel advances in both medical and surgical therapy for this disease. Recent Findings: Pain in chronic venous insufficiency is a common complication which remains poorly correlated in recent studies with the clinically observable extent of disease. Although lifestyle modification remains the foundation of treatment for pain associated

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Section: Cyanoacrylate Embolization (Cae)mentioning

confidence: 99%

Section: Advances In Minimally Invasive Treatmentmentioning

confidence: 99%

Management of Lower Extremity Pain from Chronic Venous Insufficiency: A Comprehensive Review

Orhurhu

Chu²,

Xie

et al. 2021

Cardiol Ther

View full text Add to dashboard Cite

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“…Minor complications include pain, bruising, and paresthesias which reportedly occurred at rates of 21, 15, and 4%, respectively. 15 In one retrospective study, skin pigmentation occurred at a rate of 6.9%. 16 One of the most significant complications that may occur with EVLA is endothermal heat-induced thrombosis (EHIT), by which clot related to EVLA treatment in a superficial vein is propagated into a deep vein resulting in DVT and possible pulmonary embolism.…”

Section: Endovenous Laser Ablationmentioning

confidence: 99%

Choosing the Best Treatment Approach for Axial Vein Reflux: Thermal versus Nonthermal Approaches

Shmelev

Gupta

2021

Semin intervent Radiol

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Chronic venous insufficiency is a common and treatable medical condition which has a high morbidity if left untreated, progressing to lower extremity edema, skin changes of lipodermatosclerosis, and venous ulceration. Treatment options have significantly expanded over the last several decades, shifting away from the traditional surgical approach to more minimally invasive procedures such as endoluminal venous laser ablation or radiofrequency ablation. Even more recently, several techniques using nonthermal methods to ablate varicose veins have been developed, which offer the advantage of not requiring labor-intensive and painful tumescent anesthesia to protect the surrounding tissues. These techniques include mechanochemical ablation, cyanoacrylate closure, or polidocanol microfoam injection and can be offered to a wider range of patients without the need for sedation while offering similar closure rates and improved postprocedure symptom profile. Furthermore, certain patient characteristics which might preclude or complicate the use of thermal ablation methods might not pose a problem with nonthermal nontumescent methods.

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“…Treatment with MOCA resulted in less postoperative pain/edema and a faster improvement in the Venous Clinical Severity Score (VCSS) in the short term but more hyperpigmentation compared with radiofrequency ablation (RFA) [7]. In addition, MOCA was associated with a significant reduction in rates of ecchymosis and hematoma formation and postoperative phlebitis and a shorter time to return to work compared with thermal ablation [2,8]. In comparative studies, including the Mechanochemical endovenous Ablation to RADiOf-requeNcy Ablation (MARADONA) study [7], short-term (6-month) outcomes were similar with MOCA and RFA, but there were more anatomical failures between 6 months and 3 years after MOCA than after RFA [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Micronized Purified Flavonoid Fraction-Based Venoactive Therapy After Endovenous Mechanochemical Obliteration: Prospective Comparative Study

Khryshchanovich

Nebylitsin

Косинец

2021

Drugs - Real World Outcomes

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Background Endovenous interventions and minimally invasive open procedures are effective in the management of varicose veins, but can result in post-operative pain/discomfort.Objective The objective of this study was to evaluate the clinical efficacy of micronized purified flavonoid fraction venoactive therapy for postoperative pain, vein-specific symptoms, and quality of life in patients with varicose veins following an endovenous mechanochemical ablation procedure. Methods This prospective, observational, single-center study allocated patients into two groups: Group A, micronized purified flavonoid fraction 1000 mg once daily for 30 days; Group B, no venoactive drug prescribed (control). The Clinical-Etiology-Anatomy-Pathophysiology classification system for chronic venous disorders was used to assess varicose veins; a 10-point Visual Analog Scale assessed pain syndrome intensity; the Venous Clinical Severity Score measured overall varicose vein severity; and the Chronic Venous Insufficiency QoL Questionnaire measured total quality of life. Results The study enrolled 58 patients (mean age 36.9 ± 4.1 years; 24 men) with varicose veins of C2-C4 who underwent truncal mechanochemical ablation plus mini-phlebectomy or foam sclerotherapy. Group A had significantly lower pain syndrome at days 14 and 30 compared with Group B (1.76 vs 2.20, p = 0.039; 1.38 vs 2.07, p = 0.003, respectively), and clinical symptom severity at day 30 (2.67 vs 3.13, p = 0.05). Significant differences in quality-of-life scores existed between groups at days 14 and 30 (15.21 vs 18.75, p = 0.008; 12.98 vs 16.33, p = 0.001). No micronized, purified flavonoid, fraction-related adverse effects were observed. Conclusions Micronized purified flavonoid fraction-based venoactive adjuvant therapy after mechanochemical ablation alleviated pain, reduced the severity of symptoms, and improved the quality of life in patients with varicose veins.

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Laser ablation versus mechanochemical ablation in the treatment of primary varicose veins: A randomized clinical trial

Cited by 26 publications

References 26 publications

Management of Lower Extremity Pain from Chronic Venous Insufficiency: A Comprehensive Review

Management of Lower Extremity Pain from Chronic Venous Insufficiency: A Comprehensive Review

Choosing the Best Treatment Approach for Axial Vein Reflux: Thermal versus Nonthermal Approaches

Efficacy of Micronized Purified Flavonoid Fraction-Based Venoactive Therapy After Endovenous Mechanochemical Obliteration: Prospective Comparative Study

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