Systematic review and meta-analysis of management of incompetent perforators in patients with chronic venous insufficiency

Ho, Vy T.; Adkar, Shaunak S.; Harris, E. John

doi:10.1016/j.jvsv.2021.12.088

Cited by 6 publications

(3 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…Another endoscopic surgery for vascular disease is the subfascial endoscopic perforator surgery, 4 which has been mainly used to manage incompetent perforators in patients with chronic venous insufficiency. 24 Some authors used subfascial endoscopic perforator surgery to treat the marginal vein in KTS. 4 However, endovenous radiofrequency ablation, 18 , 20 sclerotherapy, 25 and ethanol embolization 15 have become the mainstay for managing the marginal vein in recent years with the development of endovenous interventional techniques.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic Resection for Vascular Anomalies in Children

Wang¹,

Xie²,

Lin³

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

Objective: To report an innovative endoscopic surgery for subcutaneous vascular malformations and intramuscular fibro-adipose vascular anomaly (FAVA) at our center. Background: Historically, open surgical resection has been the treatment of choice. Recent advances in minimally invasive surgery have led to the successful application of endoscopic resection techniques for the surgical management of diseases of soft tissue. Methods: Patients who underwent endoscopic resection of vascular anomalies were included in this retrospective review. Data were extracted from our Vascular Anomalies Center database between September 2019 and October 2022, including sex, age, symptoms, diagnosis, sites of surgery, previous treatment, surgery, and follow-up. Results: There were 13 females and 15 males in the current study, with ages ranging from 1 to 17 years. The diagnoses included microcystic lymphatic malformation (LM) (n = 8), Klippel-Trénaunay syndrome (n = 7), venous malformation (n = 6), FAVA (n = 6), and mixed cystic LM (n = 1). Surgical sites included the lower extremity (n = 24), abdominal wall (n = 2), upper extremity (n = 1), and thoracic wall (n = 1). Five patients had an intramuscular lesion (FAVA). The endoscopic technique used 2 or 3 small ports in a gas inflation manner. Surgery included thrombectomy, radical resection, and debulking of vascular anomalies. Postoperative sclerotherapy with bleomycin was performed through a drainage tube in 6 patients with microcystic LM. Technical success was obtained in 27 patients. The conversion to open surgery was performed in one patient owing to the deep location of the lesion. No wound-related complication was observed. Conclusions: Endoscopic surgery is a minimally invasive, effective, and safe treatment for subcutaneous vascular malformations and intramuscular FAVA. This approach can set a new standard that minimizes wound complications and reduces recovery time in patients undergoing resection for benign soft-tissue lesions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Resection for Vascular Anomalies in Children

Wang¹,

Xie²,

Lin³

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

show abstract

“…Previous systematic reviews and meta-analyses have provided valuable insights into the outcomes of sclerotherapy in CVI. However, these studies have focused on specific patient populations or compared sclerotherapy with other interventions, limiting the generalizability of their findings [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Sclerotherapy to Cure Lower Limb Chronic Venous Insufficiency Grades 1-6: A Systematic Review and Meta-Analysis

Dewi,

Arimuko,

Norawati

et al. 2023

Cureus

View full text Add to dashboard Cite

Chronic venous insufficiency is a medical condition that impacts the venous system in the lower limbs. The primary characteristic of this condition is the continual elevation of pressure within the leg veins due to walking, which leads to a range of associated issues, such as discomfort, swelling, alterations in the skin, and the development of ulcers. Sclerotherapy has emerged as a potentially effective treatment for chronic venous insufficiency, involving the injection of a sclerosing agent into the affected veins. This study aimed to evaluate the effectiveness of sclerotherapy in treating chronic venous insufficiency grades 1-6 in the lower limb through a systematic review and meta-analysis. The method for conducting this research is by searching articles with relevant keywords carried out through electronic databases, such as Cochrane Library, Pubmed, and Google Scholar. The researchers conducted a comprehensive search and included randomized controlled trials and clinical trials that assessed outcomes, such as patient satisfaction, clinical resolution, quality of life (QoL), and closure rates. Statistical methods were used to analyze the data. The results of the meta-analysis from 9.670 total samples showed that sclerotherapy is the most effective therapy for reducing clinical severity in lower limb venous insufficiency patients (pooled MD = -0.85, 95% CI (-1.41, -0.29), p < 0.00001, I 2 = 99%). Sclerotherapy is the most effective therapy for increasing QoL if we use Venous Insufficiency Epidemiology and Economic Study-Quality of Life (VEINES-QOL) as a tool for measuring the QoL (VEINES-QOL scale types; pooled MD = 10.34, 95% CI (8.78, 11.90), p < 0.00001, I 2 = 0%). Additionally, sclerotherapy is a more effective therapy for increasing QoL compared to placebo (pooled MD = -1.64, 95% CI (-2.60, -0.67), p = 0.002, I 2 = 90%), deferred ablation (pooled MD = -0.22, 95% CI (-0.40, -0.03), p = 0.02), and ligation therapy (pooled MD = -1.29, 95% CI (-1.62, -0.97), p = 0.00001). It is also the most effective therapy for increasing the closure rate for 12-month duration outcome measures (pooled RR = 0.72, 95% CI (0.55, 0.94), p = 0.001, I 2 = 91%). However, high heterogeneity was observed in the meta-analysis results, indicating the need for further research to address this variability. This study contributes to the existing body of knowledge on the treatment options for chronic venous insufficiency and highlights the potential of sclerotherapy as an effective treatment modality.

show abstract

Advanced chronic venous insufficiency and the role of the incompetent perforator vein: A 100-year quest for the right strategy

Jayaraj

2024

Journal of Vascular Surgery Cases, Innovations and Techniques

View full text Add to dashboard Cite

Systematic review and meta-analysis of management of incompetent perforators in patients with chronic venous insufficiency

Cited by 6 publications

References 76 publications

Endoscopic Resection for Vascular Anomalies in Children

Endoscopic Resection for Vascular Anomalies in Children

Effectiveness of Sclerotherapy to Cure Lower Limb Chronic Venous Insufficiency Grades 1-6: A Systematic Review and Meta-Analysis

Advanced chronic venous insufficiency and the role of the incompetent perforator vein: A 100-year quest for the right strategy

Contact Info

Product

Resources

About