Long-term results of a randomized controlled trial on ultrasound-guided foam sclerotherapy combined with saphenofemoral ligation vs standard surgery for varicose veins

Kalodiki, Evi; Lattimer, Christopher; Azzam, M.; Shawish, Emad; Bountouroglou, Dimitris; Geroulakos, George

doi:10.1016/j.jvs.2011.08.040

Cited by 53 publications

(47 citation statements)

References 41 publications

(40 reference statements)

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“…The obliteration rate after UGFS was 20–50 per cent lower than in previous mid‐ and long‐term reports of RCTs and prospective cohort studies. This difference in UGFS efficacy between studies might be due to factors such as treatment protocol of UGFS, combination therapy (adding phlebectomies or high ligation) and inclusion of large‐diameter GSVs.…”

Section: Discussionmentioning

confidence: 61%

“…In a small RCT, however, additional high ligation at the SFJ in UGFS‐treated patients resulted in obliteration rates of 58 per cent, compared with 54 per cent in the conventional surgery group at 5 years' follow‐up. Adding high ligation in the UGFS group may have influenced the final results in this particular study, but more studies are needed to confirm these findings. It should be acknowledged that, if UGFS is combined with high ligation, it can no longer be considered a non‐invasive treatment.…”

Section: Discussionmentioning

confidence: 90%

“…Only one retreatment of the GSV was allowed during the first year, whereas other studies allowed more retreatments. In addition, mean volumes of injected foam in the first session were lower than in other studies. However, if UGFS is repeated over time and larger volumes of foam are used, it can be a very effective treatment.…”

Section: Discussionmentioning

confidence: 95%

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Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins

Velden¹,

Biemans

Maeseneer

et al. 2015

British Journal of Surgery

109

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 90%

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Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins

Velden¹,

Biemans

Maeseneer

et al. 2015

British Journal of Surgery

109

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“…Num outro ensaio clínico aleatorizado, com resultados a mais longo prazo ---follow-up de 5 anos ---são avaliados 73 doentes submetidos a stripping da VGS ou USGFS 33 . Este estudo foca-se nas alterações dos scores de gravidade e qualidade vida.…”

Section: Stripping Vs Escleroterapia Com Espuma Guiada Por Ecografiaunclassified

“…Este estudo foca-se nas alterações dos scores de gravidade e qualidade vida. Aos 3 e 5 anos as alterações nos scores de gravidade não apresentam diferenças significativas entre os grupos (VCSS: aos 3 anos ---p = 0,504, aos 5 anos ---p = 0,484) 33 . As alterações no score AVVQ aos 3 anos são semelhantes entre grupos (p = 0,703), mas favorecem de forma significativa o grupo submetido ao stripping aos 5 anos de follow-up (p = 0,015) 33 .…”

Section: Stripping Vs Escleroterapia Com Espuma Guiada Por Ecografiaunclassified

Abordagens cirúrgicas no tratamento de varizes

Pereira

Mesquita

Gomes

2014

Angiologia e Cirurgia Vascular

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Doença venosa crónica;Varizes; Cirurgia vascular; Stripping da veia grande safena; Técnicas minimamente invasivas Resumo A doença venosa crónica dos membros inferiores é uma patologia médica muito prevalente a nível global, sendo o refluxo da veia grande safena (VGS) a forma mais frequente de insuficiência. Acarreta um peso individual ao causar uma diminuição na qualidade de vida do doente e a nível social ao causar uma sobrecarga não desprezível nos orçamentos de saúde. Tradicionalmente a laqueação da junção safeno-femoral associada ao stripping da VGS foi a técnica gold standard no tratamento de varizes. No entanto, nos últimos anos, as técnicas minimamente invasivas têm ganho terreno sendo já consideradas alternativas seguras e eficazes ao método de stripping, mais tradicional.Foi feita uma pesquisa de artigos comparativos das várias técnicas no «Journal of Vascular Surgery», «European Journal of Vascular and Endovascular Surgery», «Phlebology: The Journal of Venous Disease», «Cochrane» e «PubMed».A revisão das técnicas foi feita com base num total de 12 artigos (estudos prospetivos, ensaios clínicos aleatorizados e não aleatorizados, estudos de coorte) com períodos de follow-up compreendidos entre as 16 semanas e os 5 anos.A curto e médio prazo as novas técnicas apresentam várias vantagens em relação ao stripping da VGS: menos dor, menor período de convalescença, melhores scores de qualidade de vida e maior satisfação do doente. No entanto, não foi possível afirmar uma superioridade das mesmas em relação ao método tradicional a longo prazo. São necessários mais estudos, com períodos de follow-up mais prolongados, com particular valor dos ensaios clínicos aleatorizados.Abstract Chronic venous disease of the lower limbs is a very common medical condition globally, with the reflux of the great saphenous vein being the most frequent form of insufficiency. * Autor para correspondência. Correio eletrónico: filipa.abelha.pereira@gmail.com (A.F. Abelha Pereira).

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Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices

Nesbitt

Bedenis

Bhattacharya³

et al. 2011

Cochrane Database of Systematic Reviews

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BACKGROUND: Minimally invasive techniques to treat great saphenous varicose veins include ultrasound-guided foam sclerotherapy (USGFS), radiofrequency ablation (RFA) and endovenous laser therapy (EVLT). Compared with conventional surgery (high ligation and stripping (HL/S)), proposed benefits include fewer complications, quicker return to work, improved quality of life (QoL) scores, reduced need for general anaesthesia and equivalent recurrence rates. OBJECTIVE: To review available randomized controlled clinical trials (RCT) data comparing USGFS, RFA, EVLT to HL/S for the treatment of great saphenous varicose veins. METHODS: Search methods: The Cochrane Peripheral Vascular Diseases (PVD) Group searched their Specialized Register (July 2010) and CENTRAL (The Cochrane Library 2010, Issue 3). In addition the authors performed a search of EMBASE (July 2010). Manufacturers of EVLT, RFA and sclerosant equipment were contacted for trial data. Selection criteria: All RCTs of EVLT, RFA, USGFS and HL/S were considered for inclusion. Primary outcomes were recurrent varicosities, recanalization, neovascularization, technical procedure failure or need for reintervention, patient quality of life (QoL) scores and associated complications. Secondary outcomes were type of anaesthetic, procedure duration, hospital stay and cost. Data collection and analysis: CN, RE, VB, PC, HB and GS independently reviewed, assessed and selected trials which met the inclusion criteria. CN and RE extracted data. The Cochrane Collaboration's tool for assessing risk of bias was used. CN contacted trial authors to clarify details. MAIN RESULTS: Thirteen reports from five studies with a combined total of 450 patients were included. Rates of recanalization were higher following EVLT compared with HL/S, both early (within four months) (5/149 versus 0/100; odds ratio (OR) 3.83, 95% confidence interval (CI) 0.45 to 32.64) and late recanalization (after four months) (9/118 versus 1/80; OR 2.97; 95% CI 0.52 to 16.98), although these results were not statistically significant. Technical failure rates favoured EVLT over HL/S (1/149 versus 6/100; OR 0.12, 95% CI 0.02 to 0.75). Recurrence following RFA showed no difference when compared with surgery. Recanalization within four months was observed more frequently following RFA compared with HL/S although not statistically significant (4/105 versus 0/88; OR 7.86, 95% CI 0.41 to 151.28); after four months no difference was observed. Neovascularization was observed more frequently following HL/S compared with RFA, but again this was not statistically significant (3/42 versus 8/51; OR 0.39, 95% CI 0.09 to 1.63). Technical failure was observed less frequently follow

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Long-term results of a randomized controlled trial on ultrasound-guided foam sclerotherapy combined with saphenofemoral ligation vs standard surgery for varicose veins

Cited by 53 publications

References 41 publications

Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins

Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins

Abordagens cirúrgicas no tratamento de varizes

Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices

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