Randomized trial of radiofrequency ablation versus conventional surgery for superficial venous insufficiency: if you don't tell, they won't know

Mendes, Cynthia de Almeida; Martins, Alexandre de Arruda; Fukuda, Juliana Maria; Parente, José Ben-Hur Ferraz; Munia, Marco Antonio; Fioranelli, Alexandre; Teivelis, Marcelo Passos; Varella, Andrea Yasbek Monteiro; Caffaro, Roberto Augusto; Kuzniec, Sérgio; Wolosker, Nelson

doi:10.6061/clinics/2016(11)06

Cited by 22 publications

(19 citation statements)

References 33 publications

(34 reference statements)

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“…Mendes CA et al; conducted a randomized controlled trial that included 18 patients and was carried out between November 2013 and May 2015. 9 Each of the lower limbs of each patient was randomly assigned to undergo either radiofrequency ablation or conventional surgery. Clinical features (hyperpigmentation, hematoma, aesthetics, pain, skin burn, nerve injury, and thrombophlebitis) were evaluated at one week, one month, and six months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Varicose vein surgery stripping method compared to radio frequency ablation

Potula

2018

Int Surg J

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Background: This randomised study was conducted to evaluate clinical, patient based outcomes after RFA and conventional surgery in a selected population. Methods: This study was conducted in the Meenakshi Medical College Hospital and Research Institute, Enathur, Kanchipuram, Tamil Nadu, India. Results: In present study, it was reported that 150 patients in total were assessed in the study, out of which, 110 were randomised, 100 underwent the intervention as a daily procedure. 50 patients underwent RFA and 50 patients had conventional surgery. In group R, males were 15, females were 35; in group C, males were 17 and females were 33. In CEAP classification, in C2 class, there were 40 in group R, 39 in group C; in C3 class, there were 8 in group R, 6 in group C; in C4-6 class, 2 were in group R and 5 were in group C. The highest total clinical severity score was 1 i.e. 30 in group R and 32 in group C. Highest venous disability score was in 1 i.e. 46 in group R, 42 in group C. Main outcomes after RFA and conventional surgery for great saphenous varicose veins. Theatre time was 80 mins in group R, 52 mins in group C, procedure time was 74 mins in group R, 46 mins in group C, pain in first week (VAS score) was 1.5 in group R, 3.5 in group C, duration of analgesia was 3 days in group R, 11 days in group C, in 4 days group R patients returned to normal activity, in 13 days group C patients returned to normal activity. Numbness/reduced sensation was followed up after 1 week and 6 week, in group R, 8 patients and in group C, 16 patients have shown numbness/reduced sensation after 1 week; 6 patients in group R and 14 patients in group C have shown numbness/reduced sensation after 6 weeks. Conclusions: This study concluded that compared to conventional surgery, RFA took longer time to perform but it gave better and significantly early outcome in patients with varicose veins.

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Section: Discussionmentioning

confidence: 99%

Varicose vein surgery stripping method compared to radio frequency ablation

Potula

2018

Int Surg J

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“…11 The sapheno-femoral junction insuffi ciency and/or refl ux disease of the VSM are blamed for superfi cial venous refl ux phenomenon in most instances. 12 Various mechanisms are accused in the formation of varicose veins. Insuffi cient valves promoting vein dilation, venous stasis, and eventually venous hypertension are known to be the principle mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Increased CRP/albumin ratio is associated with superficial venous reflux disease and varicose vein formation

Ünal¹,

Öztaş²,

Beyaz³

et al. 2021

Cor Vasa

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Nedávno byl publikován názor, že kromě zvýšeného žilního tlaku může vznik a progresi křečových žil ovlivňovat i zánět. Poměr C-reaktivního proteinu (CRP) a albuminu (CRP/albumin ratio, CAR) představuje nový marker zánětu spojený s nepříznivou prognózou u různých skupin pacientů. Cílem naší studie bylo zjistit vztah mezi průměrem varikózní velké safény (varicose greater saphenous vein, VSM) a parametrem CAR. Metody: Do studie bylo zařazeno celkem 150 pacientů s nedostatečností VSM (skupina 1, n = 114) a nepostiženými VSM (n = 36). Průměr VSM se měřil B-mode ultrazvukem a refl ux se kvantifi koval délkou uzavírání chlopně měřenou spektrální dopplerovskou křivkou. Krevní vzorky se odebíraly při zařazování pacientů do studie. Hodnota CAR se stanovuje vydělením hodnoty CRP hodnotou albuminu v séru. Výsledky: Skupinu 1 tvořilo 21 (18,4 %) mužů a 93 (81,5 %) žen; ve skupině 2 bylo 7 mužů a 29 žen. Průměrný věk pacientů v obou skupinách byl podobný (48,02 ± 12,20 roku ve skupině 1 vs. 44,9 ± 8,92 roku ve skupině 2; p = 0,44). Průměrná hodnota indexu tělesné hmotnosti (BMI) pacientů se významně nelišila (skupina 1: 26,4 ± 3,7 kg/m 2 vs. skupina 2: 25,7 ± 4,2 kg/m 2 ; p = 0,13). Průměrné hodnoty průměru VSM byly 5,70 ± 0,29 mm ve skupině 1 a 3,21 ± 0,34 mm ve skupině 2 (p = 0,0023). Průměrné hodnoty CRP a albuminu ve skupině 1 byly 6,18 ± 4,99 mg/l, resp. 4,45 ± 0,27 g/dl; ve skupině 2 to bylo 4,25 ± 2,46 mg/l, resp. 6,18 ± 1,14 g/dl (hodnota p pro CRP = 0,049, hodnota p pro albumin = 0,074). Poměr CRP/albumin ve skupině 1 činil 1,28 ± 1,34; ve skupině 2 byla naměřena hodnota 1,11 ± 1,21, tedy statisticky nevýznamný rozdíl (p = 0,58). Byla nalezena středně těsná korelace mezi průměrem VSM a poměrem CRP/albumin i refl uxem povrchových žil (r: 0,48). Závěr: Zvýšený poměr CRP/albumin je spojen se zvýšenou incidencí varixů a větším průměrem velké safény, a tedy i vyšší incidencí refl uxu povrchových žil. Zjištění podporují hypotézu, že ve vzniku křečových žil může hrát jistou úlohu systémový zánět.

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“…The effectiveness of conventional varicose surgery and its low recurrence rates are undeniable, 15,16 which makes this technique the gold standard for varicose vein treatment. Despite the increase in the use of modern techniques of venous thermal ablation and the fact that its effectiveness is comparable to conventional surgery, Mendes et al 17 demonstrated, in a randomized study, that if patients are not told the technique used, they cannot differentiate the conventional surgery from the radiofrequency ablation.…”

Section: Discussionmentioning

confidence: 99%

Clinical, ultrasonographic and histological findings in varicose vein surgery

Porciunculla

Leiderman

Altenfeder

et al. 2018

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE This study aims to correlate the demographic data, different clinical degrees of chronic venous insufficiency (CEAP), ultrasound findings of saphenofemoral junction (SFJ) reflux, and anatomopathological findings of the proximal segment of the great saphenous vein (GSV) extracted from patients with primary chronic venous insufficiency (CVI) submitted to stripping of the great saphenous vein for the treatment of lower limb varicose. METHOD This is a prospective study of 84 patients (110 limbs) who were submitted to the stripping of the great saphenous vein for the treatment of varicose veins of the lower limbs, who were evaluated for CEAP clinical classification, the presence of reflux at the SFJ with Doppler ultrasonography, and histopathological changes. We study the relationship between the histopathological findings of the proximal GSV withdrawal of patients with CVI with a normal GSV control group from cadavers. RESULTS The mean age of the patients was higher in the advanced CEAPS categories when comparing C2 (46,1 years) with C4 (55,7 years) and C5-6(66 years), as well as C3 patients (50,6 years) with C5-6 patients. The normal GSV wall thickness (mean 839,7 micrometers) was significantly lower than in the saphenous varicose vein (mean 1609,7 micrometers). The correlational analysis of reflux in SFJ with clinical classification or histopathological finding did not show statistically significant findings. CONCLUSIONS The greater the age, the greater the clinical severity of the patients. The GSV wall is thicker in patients with lower limb varicose veins, but those histopathological changes are not correlated with the disease’s clinical severity or reflux in the SFJ on a Doppler ultrasound.

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Randomized trial of radiofrequency ablation versus conventional surgery for superficial venous insufficiency: if you don't tell, they won't know

Cited by 22 publications

References 33 publications

Varicose vein surgery stripping method compared to radio frequency ablation

Varicose vein surgery stripping method compared to radio frequency ablation

Increased CRP/albumin ratio is associated with superficial venous reflux disease and varicose vein formation

Clinical, ultrasonographic and histological findings in varicose vein surgery

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